Cuts to teen pregnancy programs a senseless attack on public health
With flimsy justification, and in small type buried in routine documents, the Trump administration has informed 81 local governments and health groups that it will end grants they have received to run teen pregnancy prevention programs, two years before the grants are scheduled to end. The decision is unsettling even by the disquieting standards of this anti-science administration.
The rate at which teenagers have babies in the United States fell nearly 50 percent between 2007 and 2015, though it is still higher than in other industrialized countries. A lot of the credit for the decline belongs to health and education officials who have been coming up with new approaches to educate young people about sex and get them to make better decisions. One such effort was the Teen Pregnancy Prevention Program, created by Congress and implemented by the Obama administration in 2010. It provides five-year grants, in annual distributions, to cities, counties and health organizations to operate and evaluate public health programs aimed at teenagers. Funding for a second round of grants began in 2015, but it will now expire in 2018 instead of2020.
The department that runs the program, Health and Human Services, made no effort initially to explain its decision, which was tucked into a routine grant letter this summer. The decision came before Congress has even voted on appropriations for the next fiscal year, which begins in October. By cutting the grants short, the department is depriving recipients of about $200 million.
None of this was entirely surprising given the ideological inclinations of the people at the top of the department. Its leader is Tom Price, a far-right conservative who as a member of the House voted to end Title X, a federal family planning program, and opposed an Obama-era rule that requires insurers to cover contraception at no cost. The chief of staff to the assistant secretary responsible for adolescent health programs, including teenage pregnancy prevention grants, is Valerie Huber, who previously ran an abstinence advocacy group. Huber criticized the grant program in an opinion article published in March.
The department said in a statement that it “hit the pause button” on the grants because the “very weak evidence of positive impact of these programs stands in stark contrast to the promised results, jeopardizing the youths who were served.” This argument is based on independent evaluations of 41 of the 102 grants the Obama administration awarded in the first round. Studies showed that most projects funded by the 41 grants were no better than traditional sex education and behavioral health programs already being used in schools and local communities. Researchers found that 12 of the projects did change sex-related behavior of teenagers.
This is disingenuous. These grants were meant to allow health groups to experiment with various approaches to teenage pregnancy prevention to figure out what works best with different groups of teenagers. Some grants are used to bring programs that have worked in one setting, say, big cities, to other places, like rural areas. In other cases, the grants help health organizations try innovative methods that have not been tried extensively before. Experts say some programs failed, some worked and others did not produce conclusive results. But that is what experimentation is meant to do.
Further, Health and Human Services cannot know whether the programs funded by the second round of grants are effective because they are still underway. By cutting the grants short, department officials will make it impossible for researchers to analyze the results of these projects, and the move will hurt grant recipients and teenagers. For example, Baltimore’s health department says it will lose $3.5 million, enough money to put 20,000 middle and high school students through a reproductive health program.
Democrats in Congress have sent letters to Price demanding an explanation for the early termination of these grants. Moderate Republicans ought to join them, as should all lawmakers who share the goal of lowering the teenage birthrate by the most effective means possible.