| October 25, 1999 | Contact: | HHS Press Office (202) 690-6343 |
In his 1995 State of the Union Address, President Clinton challenged "parents and leaders all across this country to join together in a national campaign against teen pregnancy to make a difference." A group of prominent Americans responded to that challenge, forming the National Campaign to Prevent Teen Pregnancy.
On January 4, 1997, President Clinton announced a comprehensive effort to prevent teen pregnancy in this country. The new initiative, led by the Department of Health and Human Services, responded to a call from the President and Congress for a national strategy to prevent out-of-wedlock teen pregnancies and to a directive, under the new welfare law, to assure that at least 25 percent of communities in this country have teen pregnancy prevention programs in place. As the latest part of this effort, Secretary Shalala unveiled a new comprehensive guide today intended to help communities and non-profit organizations establish successful teen pregnancy prevention programs.
Building on the variety of efforts already underway, the national strategy works to prevent out-of-wedlock teen pregnancies and encourage adolescents to remain abstinent. The strategy sends the strongest possible message to all teens that postponing sexual activity, staying in school, and preparing to work are the right things to do. It strengthens ongoing efforts across the nation by increasing opportunities through welfare reform; supporting promising approaches; building partnerships; improving data collection, research, and evaluation; and disseminating information on innovative and effective practices.
Recent Trends
After rising steadily from 1987 to 1991, the birth rate for teens aged 15-19 declined for the seventh straight year in 1998, from a high of 62.1 per 1,000 teens aged 15-19 in 1991 to 51.1 in 1998. The decline was 18 percent between 1991 and 1998. The birth rate for young teenagers 15-17 years fell 5 percent from 1997 to 1998, reaching a record low, 30.4 births per 1,000 teenagers.
All 50 states had a decline in their teen birth rates between 1991 and 1997, and 10 of these states had declines of more than 20 percent or more over this period. In addition, from 1991 to 1996, the pregnancy rate for 15- to 19-year-olds fell 15 percent. Recent declines in both birth and abortion rates indicate that teen pregnancy rates are continuing to fall.
The National Strategy to Prevent Teen Pregnancy
Building on existing efforts to prevent teen pregnancy, the national strategy announced by President Clinton on January 4, 1997 was designed to strengthen the national response to prevent out-of-wedlock teen pregnancies and support and encourage adolescents to remain abstinent:
Implementing New Efforts Under Welfare Reform. Under the welfare law signed by President Clinton on August 22, 1996, unmarried minor parents are required to stay in school and live at home, or in an adult-supervised setting, in order to receive assistance. This approach was proposed by President Clinton in 1994, and incorporated into numerous state demonstration projects approved by the Administration prior to the new welfare law. The law also supports the creation of Second Chance Homes, which provide teen parents with the skills they need to become good role models and providers for their children, giving them guidance in parenting and in avoiding repeat pregnancies. The welfare law also provides $50 million a year for five years in new funding for state abstinence education programs. The Balanced Budget Act of 1997 provides funding for a national evaluation of the program. Finally, the new welfare law includes the tough child support enforcement measures President Clinton proposed in 1994, which will send the strongest possible message to young girls and boys that they should not have children until they are ready to provide for them.
Supporting Promising Approaches. The Clinton Administration continues to support innovative teen pregnancy prevention strategies tailored to the unique needs of communities. HHS-supported programs in this area already reach about 34 percent, or 1,616 communities in the United States. HHS programs are based on five principles: parental and adult involvement; strong messages of abstinence and personal responsibility; clear strategies for young people's futures; involvement by all facets of the community; and a sustained commitment to young people.
Building Partnerships. As part of the strategy, HHS has built partnerships with national, state, and local organizations. HHS is working with national youth-serving organizations to use their networks to promote activities that provide girls and boys opportunities for the future, including encouraging abstinence; with organizations working on behalf of teenagers with disabilities; and with the National Campaign to Prevent Teen Pregnancy.
Disseminating Information on Innovative and Effective Practices. On October 25, 1999, Secretary Shalala unveiled a comprehensive guide, developed in partnership with the National Campaign to Prevent Teen Pregnancy, intended to help communities and non-profit organizations establish successful local teen pregnancy prevention programs. Titled "Get Organized: A Guide to Preventing Teen Pregnancy," the publication stresses a localized approach, a long-term commitment, and careful evaluation. It also provides novel approaches for addressing teen pregnancy, including ways to involve faith leaders and the business community, suggestions on how to target young men in prevention efforts, and mechanisms for channeling community views on pregnancy prevention into effective, localized strategies for addressing the overall issue.
Sharing information about promising and successful approaches is critical to expanding teen pregnancy prevention efforts across the country. Through the national strategy, HHS continues to work with its partners to highlight innovative practices at the federal, state, and local levels and to disseminate new research and evaluation findings. The Department is also working to distribute new information on the developmental needs of youth and on the use of broad-based activities to help teenagers avoid risky behaviors leading to teen pregnancy.
Improving Data Collection, Research, and Evaluation. The national strategy is working to improve data collection, research, and evaluation to further our understanding of the magnitude, trends, and causes of teen pregnancies and births; to develop targeted teen pregnancy prevention strategies; and to assess how well these strategies work.
Sending a Strong Abstinence Message. The national strategy places a special emphasis on sending a strong abstinence message. As part of this effort, Secretary Shalala in May 1997 announced two new community grant programs to prevent teen pregnancy and promote responsible behavior. One program is aimed at teenage girls and the other at teenage boys. The grant program for girls is also part of the Secretary=s Girl Power! campaign. Each of the grant programs totals about $1 million per year, and involve public-private partnerships organized by individual communities.
In addition, the national strategy focuses on boys and young men, by working to increase understanding of motivations for both abstinence and fatherhood and by developing effective prevention strategies for boys. These efforts include working with the Administration's Fatherhood Initiative to ensure that men, including pre-teen and teenage boys, receive the education and support necessary to postpone fatherhood until they are emotionally and financially capable of supporting children. The strategy is also building on existing HHS efforts, such as the Title X Adolescent Male Initiative, that promote responsible behavior among teenage boys.
Additional HHS Programs
Girl Neighborhood Power! - Building Bright Futures for Success is challenging America's communities to become active partners in assisting 9- to 14-year-old girls to successfully navigate adolescence and achieve maximum potential. The initiative, administered by HRSA, strives to combine several elements including strong "no use" messages about tobacco alcohol, and illicit drugs with an emphasis on physical activity, nutrition, abstinence, mental health, social development, and future careers.
The Center for Disease Control's Community Coalition Partnership Program for the Prevention of Teen Pregnancy has supported demonstration grants for the prevention of teen pregnancies since 1995. Coalitions of local and public and private agencies and organizations in communities with high rates of teen pregnancy have been working over the last two years to develop community action plans, coordinate efforts to reduce teen pregnancy, identify gaps in current programs and services, target existing resources, and design evaluation plans. CDC awarded approximately $250,000 per year for two years to 13 communities in 11 states to help these communities mobilize and organize their resources. For FY 1998, a total of $13.7 million was made available to help the 13 community coalition partnerships implement their action plans and evaluate their impact, as well as to support related data collection, evaluation, and dissemination activities.
State Children's Health Insurance Program (CHIP) was established by the Balanced Budget Act of 1997 under Title XXI of the Social Security Act. This program, administered by the Health Care Financing Administration (HCFA), enables states to provide health insurance coverage to uninsured targeted low-income children. States have the opportunity to involve communities as they design and implement their CHIP programs so that the new programs, including teen pregnancy prevention programs, may be an additional avenue to provide services to adolescents at risk.
The Abstinence Only Education Program was part of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 to enable states to provide abstinence education through activities such as mentoring, counseling, and adult supervision designed to promote abstinence from sexual activity until marriage. The program, administered by the Health Resources and Services Administration (HRSA), has a mandatory appropriation of $50 million for each Fiscal Year from 1998 through 2002. Reproductive Health and Family Planning Services (under Title X of the Public Health Service Act) are provided to nearly 5 million persons each year, nearly one third of whom are under 20 years of age. Abstinence counseling and education are an important part of the Title X service protocol for adolescent clients. These services are provided by 84 grantees with more than 4,000 clinic locations.
These sites offer reproductive health services including pregnancy prevention, family planning, and diagnosis of sexually transmitted diseases, either on site or by referral. The program has also launched an adolescent male initiative called the "Young Men/Family Planning Partnership Training Program." Under this initiative, Title X clinics employ male high school students as interns while also providing training in clinic operation and peer education; assisting in identifying career paths in allied health and related occupations; and increasing their use of services in a family planning setting.
Healthy Schools, Healthy Communities, a Health Resources and Services Administration program created in 1994, has established school-based health centers in 26 communities in 20 states to serve the health and education needs of children and youth at high risk for poor health, teenage pregnancy, and other problems. For the first three years of the program, $1 million each year was provided to fund health education and promotion programs that were coordinated with the health services grants.
The Social Services Block Grant (SSBG) (under Title XX of the Social Security Act) provides funding to prevent, reduce, or eliminate dependency; achieve or maintain self-sufficiency; prevent neglect, abuse, or exploitation of children and adults; prevent or reduce inappropriate institutional care; and provide admission or referral for institutional care when other forms of care are inappropriate. SSBG Grants are made directly to the 50 states, the District of Columbia, Puerto Rico, Guam, the Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands to fund social services tailored to meet the needs of individuals and families residing within each jurisdiction.
The Community Services Block Grant, which operates in all 50 states, the District of Columbia, and the territories, enables local community agencies to provide low-income populations, including youth at risk, with job counseling, summer youth employment, GED instruction, crisis hotlines, information and referral to health care, and other services.
The Independent Living Program, run by the Administration for Children and Families, provides funds to states to support activities ranging from educational programs to programs that help young people who are making the transition from foster care to independent living to avoid early parenthood. This program supports activities in all 50 states and the District of Columbia.
Youth Programs including Runaway and Homeless Youth Programs, Transitional Living Programs, and the Youth Sports Program, address a wide range of risk factors for teen pregnancy. Together, these programs operate in 500 communities in 50 states and the District of Columbia.
Healthy Start, administered by HRSA, has 62 projects to reduce infant mortality in the highest-risk areas and to improve the health and well-being of women, infants, and their families. Among a broad array of services provided (including state prenatal hotlines), thousands of teenagers participate in prevention programs exclusively designed for adolescents. The programs encourage healthy lifestyles, youth empowerment, sexual responsibility, conflict resolution, goal setting, and the enhancement of self-esteem.
Maternal and Child Health Services Block Grant (Title V) funds support a variety of adolescent health programs in 57 states and jurisdictions, including adolescent pregnancy prevention programs, state adolescent health coordinators, family planning, technical assistance, and other prevention services.
The Adolescent Family Life Program (AFL), created in 1981, supports research into the causes and consequences of adolescent pregnancy; demonstration projects that provide health, education, and social services to pregnant and parenting adolescents, their children, male partners, and families; and programs aimed at promoting abstinence among pre-adolescents and adolescents as the most effective way of preventing adolescent pregnancies, sexually transmitted diseases, and HIV/AIDS. In FY 1997, the AFL program funded 83 projects in 37 states and the District of Columbia. AFL is administered by the Office of Population Affairs.
Empowerment Zones and Enterprise Communities in 105 rural and urban areas in 43 states and the District of Columbia have been awarded grants to stimulate economic and human development and to coordinate and expand support services. As they implement their strategic plans, some sites are including a focus on teenage pregnancy prevention and youth development.
Health Education in Schools supports the efforts of every state and territorial education agency to implement local school health programs to prevent the spread of HIV and sexually transmitted diseases (STDs). Assistance is also provided to 13 states to build an infrastructure for school health programs. Efforts are targeted at preventing early sexual activity, STDs, HIV, drug and alcohol abuse, tobacco use, and injuries.
Community and Migrant Health Centers, including family and neighborhood health centers, operate in 3,032 community-based sites through 685 center grantees in all 50 states, the District of Columbia, and six territories. The centers provide primary and specialized health and related services to medically-underserved adolescents. Some centers include special hours or clinics for adolescent patients.
Indian Health Service (IHS) provides a full range of medical services for American Indians and Alaska Natives. IHS supports projects targeted at preventing teenage pregnancy, and its prevention and treatment programs also have a special emphasis on youth substance abuse, child abuse, and women's health care.
Drug Treatment and Prevention Programs include services to prevent first time and repeat pregnancies among teenagers. One hundred twenty-two residential substance abuse treatment programs for pregnant and postpartum women, as well as for women with dependent children, receive support to provide family planning, education, and counseling services in 39 states, the District of Columbia, and the Virgin Islands. Also, 25 programs to prevent substance use and other adverse life outcomes serve high-risk female teens in 13 states and the District of Columbia.
Health Care and Promotion under Medicaid provides Medicaid-eligible adolescents under age 21 with access to a comprehensive range of preventive, primary, and specialty services within its Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program.
The Medicaid program also funds family planning services at an enhanced match rate for states. The federal government pays 90 percent of state expenditures for Medicaid family planning services, while the state funds the remaining 10 percent. The enhanced match encourages states to fund family planning programs which include patient counseling and education concerning pregnancy prevention and reproductive health.
Evaluation and Research
HHS has conducted research, surveillance, demonstrations, and evaluations on an ongoing basis to gather and provide information and technical assistance on the magnitude, trends, and causes of teenage pregnancy and on prevention programs and approaches that work, including:
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