[House Hearing, 106 Congress]
[From the U.S. Government Publishing Office]
REDUCING NONMARITAL BIRTHS
=======================================================================
HEARING
before the
SUBCOMMITTEE ON HUMAN RESOURCES
of the
COMMITTEE ON WAYS AND MEANS
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTH CONGRESS
FIRST SESSION
__________
JUNE 29, 1999
__________
Serial 106-35
__________
Printed for the use of the Committee on Ways and Means
U.S. GOVERNMENT PRINTING OFFICE
65-696 CC WASHINGTON : 2000
_______________________________________________________________________
For sale by the U.S. Government Printing Office
Superintendent of Documents, Congressional Sales Office, Washington, DC
20402
COMMITTEE ON WAYS AND MEANS
BILL ARCHER, Texas, Chairman
PHILIP M. CRANE, Illinois CHARLES B. RANGEL, New York
BILL THOMAS, California FORTNEY PETE STARK, California
E. CLAY SHAW, Jr., Florida ROBERT T. MATSUI, California
NANCY L. JOHNSON, Connecticut WILLIAM J. COYNE, Pennsylvania
AMO HOUGHTON, New York SANDER M. LEVIN, Michigan
WALLY HERGER, California BENJAMIN L. CARDIN, Maryland
JIM McCRERY, Louisiana JIM McDERMOTT, Washington
DAVE CAMP, Michigan GERALD D. KLECZKA, Wisconsin
JIM RAMSTAD, Minnesota JOHN LEWIS, Georgia
JIM NUSSLE, Iowa RICHARD E. NEAL, Massachusetts
SAM JOHNSON, Texas MICHAEL R. McNULTY, New York
JENNIFER DUNN, Washington WILLIAM J. JEFFERSON, Louisiana
MAC COLLINS, Georgia JOHN S. TANNER, Tennessee
ROB PORTMAN, Ohio XAVIER BECERRA, California
PHILIP S. ENGLISH, Pennsylvania KAREN L. THURMAN, Florida
WES WATKINS, Oklahoma LLOYD DOGGETT, Texas
J.D. HAYWORTH, Arizona
JERRY WELLER, Illinois
KENNY HULSHOF, Missouri
SCOTT McINNIS, Colorado
RON LEWIS, Kentucky
MARK FOLEY, Florida
A.L. Singleton, Chief of Staff
Janice Mays, Minority Chief Counsel
------
Subcommittee on Human Resources
NANCY L. JOHNSON, Connecticut, Chairman
PHILIP S. ENGLISH, Pennsylvania BENJAMIN L. CARDIN, Maryland
WES WATKINS, Oklahoma FORTNEY PETE STARK, California
RON LEWIS, Kentucky ROBERT T. MATSUI, California
MARK FOLEY, Florida WILLIAM J. COYNE, Pennsylvania
SCOTT McINNIS, Colorado WILLIAM J. JEFFERSON, Louisiana
JIM McCRERY, Louisiana
DAVE CAMP, Michigan
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Ways and Means are also published
in electronic form. The printed hearing record remains the official
version. Because electronic submissions are used to prepare both
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unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
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C O N T E N T S
----------
Page
Advisory of June 22, 1999 announcing the hearing................. 2
WITNESSES
U.S. Department of Health and Human Services, Stephanie Ventura,
Senior Researcher, National Center for Health Statistics,
Centers for Disease Control and Prevention..................... 14
------
Alan Guttmacher Institute, Cory L. Richards...................... 80
American Public Human Services Association, John Sciamanna....... 108
Mathematica Policy Research, Inc., University of Pennsylvania,
Rebecca A. Maynard............................................. 92
National Campaign to Prevent Teen Pregnancy, Brenda Rhodes Miller 96
Nelson A. Rockefeller Institute of Government, Richard P. Nathan. 37
New Jersey Department of Human Services, Edward Tetelman......... 104
Preserving Family Well-Being Foundation, Pat Funderburk Ware..... 78
Rector, Robert, Heritage Foundation.............................. 45
Sawhill, Isabel V., Brookings Institution, and National Campaign
to Prevent Teen Pregnancy...................................... 68
Westat, Nicholas Zill............................................ 25
REDUCING NONMARITAL BIRTHS
----------
TUESDAY, JUNE 29, 1999
House of Representatives,
Committee on Ways and Means,
Subcommittee on Human Resources,
Washington, DC.
The Subcommittee met, pursuant to notice, at 10:05 a.m., in
room B-318, Rayburn Office Building, Hon. Nancy L. Johnson
(Chairman of the Subcommittee), presiding.
[The advisory announcing the hearing follows:]
ADVISORY
FROM THE
COMMITTEE
ON WAYS
AND
MEANS
SUBCOMMITTEE ON HUMAN RESOURCES
CONTACT: (202) 225-1025
FOR IMMEDIATE RELEASE
June 22, 1999
No. HR-8
Johnson Announces Hearing
on Reducing Nonmarital Births
Congresswoman Nancy L. Johnson (R-CT), Chairman, Subcommittee on
Human Resources of the Committee on Ways and Means, today announced
that the Subcommittee will hold a hearing on reducing nonmarital
births. The hearing will take place on Tuesday, June 29, 1999, in room
B-318 of the Rayburn House Office Building, beginning at 10:a.m.
Oral testimony at this hearing will be from invited witnesses only.
Witnesses will include officials from Congressional agencies, program
administrators, researchers, and advocates. However, any individual or
organization not scheduled for an oral appearance may submit a written
statement for consideration by the Committee and for inclusion in the
printed record of the hearing.
BACKGROUND:
For several generations, both the number and percentage of American
children born outside marriage has been increasing. Simultaneously,
social science evidence has been accumulating to demonstrate that
nonmarital births are bad for the children involved, their parents, and
society. Among other findings, children born outside marriage are more
likely to be poor, perform poorly in school, drop out of school, have
criminal records, and have nonmarital births themselves. Similarly,
mothers giving birth outside marriage are more likely to be poor, go on
welfare, become dependent on welfare, and be unemployed. However,
historical trends also suggest that the Nation is making some progress
in its fight to stanch the increase in babies born outside marriage.
The 1996 welfare reform law (P.L. 104-193) contained numerous
provisions designed to reduce nonmarital births. These included funds
for abstinence education programs, strong paternity establishment
requirements, a requirement that teen mothers live at home or with a
responsible adult, a requirement that teen mothers stay in school, and
a cash bonus for States that decrease their nonmarital birth rate while
decreasing their abortion rate.
In announcing the hearing, Chairman Johnson stated: ``Along with
the related problem of declining marriage rates among low-income
Americans, the increase in nonmarital births is the nation's leading
social problem. We have found that the nation's shocking level of
births outside marriage is correlated with almost all our other social
ills. Now, for the first time in several generations, we seem to
actually be making progress in reducing the rate of teen births outside
marriage and at least stopping the increase in the ratio of all
American births that occur outside marriage. We are holding this
hearing to find out whether any of the policies we enacted in 1996 are
having an impact on the level of nonmarital births and to search for
additional steps we can take to encourage young people to defer
childbearing until marriage.''
FOCUS OF THE HEARING:
The hearing will focus on four issues. First, historical trends in
both the illegitimacy ratio and the rate of nonmarital births will be
reviewed. Second, the numerous policies included in the 1996 welfare
reform law to reduce nonmarital births will be summarized and their
impact on historical trends in nonmarital births assessed. Further, the
hearing will assess the actions being taken by State and local agencies
to implement the Federal policies on nonmarital births as well as
additional policies developed at the State and local level. Third, the
hearing will review whether other societal trends, such as the
increased fear of sexually transmitted diseases and the increased use
of long-term contraceptives, have had an impact on nonmarital birth
rates. Fourth, the hearing will examine new policies that should be
considered to ensure that the Nation continues to make progress in
reducing the number of children born outside marriage.
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Means, U.S. House of Representatives, 1102 Longworth House Office
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noted above.
Chairman Johnson of Connecticut [presiding]. Good morning,
everyone.
Today, we move forward in the series of hearings we have
planned to methodically and comprehensively fulfill our
obligation to oversee the implementation and performance of the
welfare reform legislation of 1996.
This is a hearing I have been looking forward to because I
was not one of those who believed that funding abstinence
programs could have much effect on nonmarital birthrates. I
believed then and am more convinced than ever now that welfare
reform will have an effect on the number of children born out
of wedlock, and I think this is important because of the
enormous economic and emotional support children need in
today's world. But this hearing will give us the first good
information on the effect of the provisions in the 1996 Welfare
Reform bill and the opportunity we may have to discourage
nonmarital births.
There is overwhelming data that nonmarital births is one of
the Nation's two or three greatest social problems. School
failure, school dropout, welfare use, poor jobs, crime and
delinquency and a host of other problems do unfortunately
correlate with being born to unmarried mothers, that is,
without the full support economically and emotionally of two
adults.
There also seems to be considerable agreement that if we
could substantially reduce the number of nonmarital births, we
would improve the lives of millions of adults and children and
reduce the severity of some of the social problems just listed.
As we will see in the presentations by Dr. Ventura and
several of the witnesses, for the first time since the early
1960s, today we actually have good news about trends in
nonmarital births. The teen birthrate has been declining since
the early 1990s, and the overall ratio of nonmarital births has
been more or less stable for 3 years.
These are welcome and hopeful developments, but do these
trends signal a true change in nonmarital births or simply a
pause in their relentless increase? The purpose of today's
hearing is to review these questions and discuss provisions we
put in the 1996 Welfare Reform bill, designed to reduce
nonmarital births.
I am pleased that the Congressional Research Service has
published two concise and exceptionally useful papers on
nonmarital births. One of these summarizes the provisions of
the 1996 Welfare Reform law designed to reduce these births,
and the other is a brief overview of some of the major issues.
We have placed copies of both papers in the Members' folders
and copies are available on the table.
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Chairman Johnson of Connecticut. It is my intent to try to
determine the effectiveness of the 1996 provisions and gain
better insight into how this subcommittee can better support
families and discourage nonmarital births.
What effect did the changes in the law have? What role--the
very public debate on this issue during the welfare reform
debate, what role did that public debate play? That was the
first public discussion of the discouraging data associated
with these kids's futures, as well as with the future of their
moms and dads. I am anxious to hear what our distinguished
witnesses have to say about these vital issues and especially
about whether additional policy changes could help.
[The opening statement follows:]
Statement of Chairman Nancy L. Johnson, a Representative in Congress
from the State of Connecticut
Today we move forward in the series of hearings we have
planned to methodically and comprehensively fulfill our
obligation to oversee the implementation and performance of the
welfare reform this Congress passed in 1996. This is a hearing
I have been looking forward to because I was not one of those
who believed that funding abstinence programs could have much
effect on nonmarital birthrates. I believed then and am more
convinced than ever now that welfare reform will reduce the
number of children born out of wedlock and I think that is
important because of the enormous economic and emotional
support children need in today's world. This hearing will give
us the first good information on this important matter for kids
and families.
There is now overwhelming data that nonmarital births is
one of our nation's two or three greatest social problems.
School failure, school dropout, welfare use, poor jobs, crime
and delinquency, and a host of other problems do,
unfortunately, correlate with being born to unmarried mothers,
that is without the full support--both economic and emotional--
of two adults. There also seems to be considerable agreement
that if we could substantially reduce the number of nonmarital
births, we would improve the lives of millions of adults and
children and reduce the social problems just listed.
As we will see in the presentations by Dr. Ventura and
several other witnesses, for the first time since the early
1960s, today we actually have good news about trends in
nonmarital births. The teen birthrate has been declining since
the early 1990s and the overall ratio of nonmarital births has
been more or less stable for 3 years. These are welcome and
hopeful developments. But do these trends signal a true change
in nomarital births or simply a pause in their relentless
increase?
The purpose of today's hearing is to review these questions
and to discuss provisions we put in the 1996 Welfare Reform
bill designed to reduce nonmarital births. I am very pleased to
announce that the Congressional Research Service has published
two concise and exceptionally useful papers on nonmarital
births. One of these summarizes the provisions of the 1996
welfare reform law designed to reduce these births; the other
is a brief overview of some of the major issues. We have placed
copies of both papers in the members folders and copies are
available on the table.
It is my intent to try to determine the effectiveness of
the 1996 provisions and gain better insight into how this
Subcommittee can better support families and discourage
nonmarital births. What role did the changes in the law play?
What role did the very public debate on this issue during the
welfare reform debate play? That was the first public
discussion of the discouraging data associated with these kids'
futures, as well as that of their moms and dads.
I'm anxious to hear what our distinguished witnesses have
to say about these vital issues--and especially about whether
additional policies could be helpful.
And I would like to yield to my colleague, Mr. Cardin.
Mr. Cardin. Well, thank you, Madam Chair, and let me thank
you for holding these hearings. I, too, look forward to
listening to the experts on the panels that we have today.
Birth to teenage mothers has been declining for nearly a
decade, and that is certainly good news. I, for one, have
always felt that we should make a higher national priority the
problems of teenage moms. The question before this panel is
what government policies or societal changes promote this
reduction and what we can do to maintain the progress that we
have already made in this area.
I am one of the Members who voted the 1996 Welfare Reform
law, and I hope that the measures that emphasize parental
responsibility would have a positive impact on reducing the
number of teenage pregnancies, parental responsibility for both
the mother and the father. However, since the reductions in
teenage birthrates has now been going on for about 10 years, we
may need to look a little further for explanation as to why we
have been making some progress in this area.
This recent progress should not deter us from working to
further reduce the number of children having children,
especially since our Nation's teenage pregnancy rate is still
much higher than nearly every other industrial nation of the
world. However, there may be some disagreement about how to
pursue this goal. For example, Governor George W. Bush last
week, reportedly suggested that teaching abstinence and safe
sex at the same time sends, ``a contradictory message.''
I worry this position could mean less information and
advice on contraception for young women. It is one thing to say
that abstinence should be our first message to young people,
but saying that it should be our only message could take us
backwards, not forwards, in our effort to reduce teenage
pregnancies. Furthermore, I don't know how one can oppose a
woman's right of choice and at the same time also oppose
providing her access to information that might prevent a
pregnancy.
In general, I believe our efforts to highlight the merits
of waiting to have sex does not require us to deprive teenagers
of information about contraception. After all, there is no
evidence to suggest that teaching teenagers about safe sex
increases their sexual activity.
Madam Chair, as we begin these hearings today on this
subject, I look forward to our experts helping us as we try to
develop the right policies for our Nation to reduce teenage
pregnancy.
Thank you very much.
Chairman Johnson of Connecticut. I thank you for your
opening comments.
Now, we will hear from the first panel, Stephanie Ventura
of the National Center for Health Statistics, Centers for
Disease Control and Prevention, and Nicholas Zill, the vice
president and director of Child and Family Study Area, Westat,
Inc., from Rockville. Come join us.
Ms. Ventura, if you will begin. We are very pleased to have
your testimony from the Centers for Disease Control.
STATEMENT OF STEPHANIE VENTURA, SENIOR RESEARCHER, NATIONAL
CENTER FOR HEALTH STATISTICS, CENTERS FOR DISEASE CONTROL AND
PREVENTION, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Ms. Ventura. Madam Chair and Members of the Subcommittee, I
am Stephanie Ventura, a Senior Researcher at the National
Center for Health Statistics, an agency within the Centers for
Disease Control and Prevention. Thank you for inviting me here
today to speak with you about trends in births to unmarried
women. The data I will draw on are from the National Vital
Statistics System, one of more than a dozen data systems that
the CDC/NCHS operates to allow us to profile the health of
Americans.
By working with State health departments, we obtain data
recorded on birth certificates, which include an item on
marital status, allowing us to monitor trends in nonmarital
births. At NCHS, I have worked with the data on nonmarital
births for over 30 years.
I will be presenting both broad trends and some
illustrative details on nonmarital births. Additional
information is included in my formal testimony. Much of this
detail is important to grasping what has proven to be a complex
social and health issue. As you sort through all of the
specifics, however, I want to make sure that I convey these
four important points.
No. 1, nonmarital births skyrocketed from 1940 to 1990, but
the trends have stabilized in the 1990s, with a decline in the
nonmarital birthrate since 1994.
No. 2, teens are not the only women having nonmarital
births. In fact, two-thirds of nonmarital births are to women
20 and older.
No. 3, teen birthrates have declined considerably since
1991 with declines in all States and in all racial and ethnic
groups.
And No. 4, nonmarital birthrates and teen birthrates have
fallen for all population groups, but most sharply for black
women.
Let's look first at the long-term historical trends in
nonmarital births, using these three key measures as shown in
the first chart. These are, No. 1, the birthrate for unmarried
women; No. 2, the number of births to unmarried women; and No.
3, the percent of all births that are to unmarried women.
No matter how you look at the statistics, nonmarital
childbearing rose dramatically during the half century from
1940 to 1990. The birthrate for unmarried women, which
describes the proportion of unmarried women who give birth,
increased more than sixfold overall, with increases in all age
groups over this period as shown in the second chart. The
rising number of nonmarital births was due in large part to the
increased birthrates for unmarried women and the steep
increases in the number of unmarried women in the childbearing
ages.
The percent of all births that are to unmarried women rose
sevenfold. Because of increases in birthrates for unmarried
women and in the number of unmarried women, as I just
described, and the 40 percent drop in birthrates for married
women from the 1960s to the late 1980s. The percent of births
to unmarried women increased substantially in all age groups as
shown in this next chart.
In contrast to previous decades, during the 1990s,
nonmarital childbearing has stopped rising and even declined in
some age and race groups. The birthrate has declined since
1994. The total number of nonmarital births has stabilized in
the last several years, and since 1994, the proportion of
births to unmarried women has been unchanged at 32 percent.
Birthrates for unmarried black women have historically been
higher than for unmarried white women, but the disparity has
narrowed in recent years. In the 1990s, the rate for non-
Hispanic white women has declined 5 percent, while the rate for
black women fell 19 percent. The rate for unmarried Hispanic
women, which is now the highest of any group, has declined 10
percent.
Let's look now at teen births. Although teen birth and
nonmarital birth patterns are often considered interchangeable,
these rates are not the same. The birthrate for teens aged 15
to 19 dropped by 16 percent between 1991 and 1997, and it has
continued to
decline through June 1998. Of particular note, the birthrate
for second births to teens who have had a first birth has
dropped by 21 percent since 1991, as shown in this next chart.
Despite the declines in teen birthrates, most births that
occur to teenagers are to unmarried teenagers. Birthrates for
unmarried teens have declined steadily since 1994, halting
steep increases which began in the mid-1970s. Rates fell for
all unmarried teenagers, but again, with the largest decline
for black teens.
What are some of the facts behind these recent declines?
Data from three HHS-operated or -sponsored surveys show that
the proportion of teenagers who are sexually experienced has
stabilized and even declined in the 1990s. In addition,
teenagers are now more likely to use contraceptives at first
intercourse, especially condoms. About 12 percent of all
teenagers using contraception and 25 percent of black teenagers
are using long-lasting hormonal methods, including injectable
and implant contraceptives. These changes in contraceptive use
are also found for older women.
In summary, I hope that my testimony has reinforced the
four major points I made when I began.
Thank you for the opportunity to present this data. I would
be pleased to answer any questions you may have.
Chairman Johnson of Connecticut. Thank you very much, Ms.
Ventura.
[The prepared statement follows:]
Statement of Stephanie Ventura, National Center for Health Statistics,
Centers for Disease Control, U.S. Department of Health and Human
Services
Madam Chairman and Members of the Subcommittee, I am
Stephanie Ventura, a senior researcher at the National Center
for Health Statistics (NCHS), an agency within the Centers for
Disease Control and Prevention (CDC). Thank you for inviting me
to speak with you today about the trends and variations in
births to unmarried women. The data I will draw on are from the
National Vital Statistics System, one of more than a dozen data
systems that the CDC/NCHS maintains that allow us to profile
the health and health care experiences of Americans. At NCHS, I
have worked with the data on nonmarital births for over thirty
years.
CDC/NCHS is the Nation's principal health statistics
agency. In addition to the vital statistics system, we obtain
our information through ongoing and special studies, including
surveys where we interview a representative sample of Americans
about their health, surveys where we conduct direct physical
examinations, and surveys using hospital data and data from
other providers of care. These data systems provide information
on a broad range of health and health-related topics, ranging
from birth to death and covering such topics as teen pregnancy,
blood lead levels in children, incidence of overweight,
cholesterol levels, immunizations, health insurance and access
to care, the use of surgical procedures, and life expectancy.
Data from CDC/NCHS are among the most fundamental measures
supporting health policy decisions, public health practice, and
research.
Today I will be talking with you about statistics from our
National Vital Statistics System. By working with State health
departments, we obtain data recorded on birth certificates.
These certificates, initially filed as part of the vital
registration process mandated in each state, are a rich
resource for health and demographic research. It is through
these documents that we obtain data on teen births, prenatal
care, low birthweight, smoking during pregnancy, and other
important measures. Birth certificates include an item on
marital status, and this item allows us to monitor trends in
nonmarital births.
Overview
I will be presenting both broad trends and some
illustrative details on nonmarital births. Much of this detail
is important to grasping what has proven to be a complex social
and health issue. As you sort through all of the specifics,
however, I want to make sure that I convey these four important
points.
Nonmarital births skyrocketed from 1940 to 1990
but the trends have stabilized in the 1990's, with a decline in
the nonmarital birth rate since 1994.
Teens are not the only women having nonmarital
births; in fact two-thirds of nonmarital births are to women 20
and older.
Teen birth rates have declined considerably since
1991, with declines in all states and in all racial and ethnic
groups.
Nonmarital birth rates and teen birth rates have
fallen for all population groups, but most sharply for black
women.
Long Term Historical Trends, 1940-90
Let's look first at the long-term historical trends in
nonmarital births, using three key measures. These are (1) the
birth rate for unmarried women, (2) the number of births to
unmarried women, and (3) the percent of all births that are to
unmarried women. No matter how you look at the statistics,
nonmarital childbearing rose dramatically during the half
century from 1940 to 1990, with somewhat larger increases in
the 1980's than in previous decades (table 1, figure 1).
The birth rate for unmarried women, which describes the
proportion of unmarried women who give birth, increased more
than six-fold overall. Birth rates increased for women in all
age groups over this period (table 2, figure 2).
The two key trends contributing to the rising numbers of
nonmarital births through 1990 were the increased birth rates
for unmarried women and the steep increases in the number of
unmarried women in the childbearing ages. The number of
unmarried women increased substantially as more and more women
from the large baby-boom generation postponed marriage, a trend
that shows no sign of abating with the current generation. In
other words, the combination of more unmarried women who were
also more likely to have a baby produced substantial increases
in the number of nonmarital births.
The percent of all births that are to unmarried women rose
steeply because of three concurrent trends: The increases in
birth rates for unmarried women of all ages; the increases in
the number and proportion of women who are unmarried, explained
above; and the considerable drop in birth rates for married
women (dropping 40 percent from 1960 to the late 1980's) (table
3, figure 3). Thus, the percent of all births that were to
unmarried women rose because births to unmarried women
increased while births to married women declined.
Data That Illustrate These Long-Term Trends
The birth rate increased from 7 births per 1,000
unmarried women aged 15-44 in 1940 to 44 per 1,000 in 1990
(tables 1 and 2, figure 1).
Trends in rates have been cyclical for most age
groups, except the rates for teenagers. Teen rates rose, almost
without interruption, from 1940 to 1990. Rates for women in
their twenties and thirties rose steeply in the 1980's, by at
least 50 percent (table 2, figure 2).
Major changes in marriage patterns produced rapid
growth in the number of unmarried women in all age groups. Two-
thirds of women in their early twenties and about 40 percent of
women in their late twenties are currently unmarried.
The number of nonmarital births rose 13-fold
between 1940 and 1990, from 89,500 in 1940 to 1.2 million in
1990 (table 1 and figure 1).
The percent of all births that occurred to
unmarried women rose seven-fold, from 4 percent in 1940 to 28
percent in 1990 (table 1 and figure 1). Increases were
substantial in all age groups (table 4 and figure 4).
Increases in birth rates for unmarried women aged
20 and older have contributed to striking shifts in the age
distribution of nonmarital births. By 1990, only one-third were
to teenagers compared with half in 1975.
Current Trends
In contrast to previous decades, during the 1990's
nonmarital childbearing has stopped rising and even declined in
some age and race groups. The total number of nonmarital births
rose just 8 percent between 1990 and 1997, and has stabilized
in the last several years. Most of this increase was due to the
continued increase in the number of unmarried women. Birth
rates for unmarried women, the other factor, have stabilized
and in some cases declined in the mid 1990's (tables 1 and 2,
figure 2). More importantly, the proportion of births to
unmarried women has increased relatively little in the 1990's.
Since 1994, it has been essentially unchanged at 32 percent,
reflecting stability in birth rates for unmarried women and
modest increases in the number of unmarried women, coupled with
declines in birth rates for married women.
I will now review some of the current patterns in
nonmarital childbearing.
Variations by Race and Hispanic Origin
Nonmarital birth rates differ considerably by race and
Hispanic origin. Reliable rates can be computed for white,
black and Hispanic women; population data by marital status and
race have not been available to allow us to compute similar
rates for other race and ethnicity groups except in census
years. Rates for unmarried black women have historically been
higher than for white women, but the disparity has narrowed
because birth rates for unmarried white women have increased
more steadily than for unmarried black women (table 2).
The rate for unmarried white women more than doubled from
18 per 1,000 in 1980 to 38 in 1994, and has since declined
slightly to 37. In contrast, the rate for unmarried black women
increased from 81 in 1980 to 91 in 1989 (about 12 percent), and
has declined steadily since to 73 per 1,000 in 1997 (down about
19 percent) (table 2).
Rates for unmarried Hispanic women are available only since
1990. The rate was highest in 1994, at 101 per 1,000, and has
dropped 10 percent since. The birth rate for unmarried Hispanic
women is the highest of any race/ethnicity group; this is
consistent with the overall fertility patterns for Hispanic
women.
Rates for unmarried women by age within race and Hispanic
origin groups show essentially the same trends as the overall
rates by race and ethnicity. Rates have fallen steeply for
unmarried black women under age 35 (table 2).
Birth rates for married black women have declined even more
than rates for unmarried black women and the rates are now much
closer to each other (table 3). As a result, the proportion of
births to unmarried black women remains high, 69 percent in
1997. Birth rates for married as well as unmarried non-Hispanic
white and Hispanic women have generally stabilized or declined.
As a consequence, the proportions of births to unmarried non-
Hispanic white and Hispanic women have changed much less since
the early 1990's compared with previous years. In 1997, 22
percent of births to non-Hispanic white women and 41 percent of
births to Hispanic women were nonmarital.
Teen Birth Rate Trends
Let's look now at teen births. Although teen birth and
nonmarital birth patterns are often considered interchangeable,
these rates are not the same. Teen birth rates have declined
considerably since 1991. The birth rate for teens aged 15-19
dropped 16 percent between 1991 and 1997, and it has continued
to decline through June 1998, according to preliminary data.
The rate for younger teenagers, 15-17 years, fell 17 percent
while the rate for older teens 18-19 dropped 11 percent. Of
particular note, the birth rate for second births to teens who
have had a first birth has dropped substantially--by 21
percent--since 1991 (figure 5).
Despite the declines, however, most births that occur to
teenagers are to unmarried teens. Birth rates for unmarried
teens have declined steadily since 1994. The rate for unmarried
teens aged 15-17 fell by 12 percent from 1994 to 1997, while
the rate for older unmarried teens aged 18-19 fell 7 percent.
To put these recent declines in perspective, I should note that
from 1980 to 1994, the rate for unmarried teens aged 15-17 rose
55 percent, while the rate for teens 18-19 years rose 80
percent. Birth rates have dropped for unmarried non-Hispanic
white, black, and Hispanic teenagers, but they dropped the most
for black teenagers (table 2).
Behavioral Changes and their Impact
Data from CDC/NCHS' National Survey of Family Growth, CDC's
Youth Risk Behavior Survey, and the NIH-sponsored National
Survey of Adolescent Males can help explain some of the recent
declines in teen births and in nonmarital births. These three
separate surveys have all shown that the proportion of female
and male teenagers who are sexually experienced has stabilized
and even declined in the 1990's, reversing the steady increases
that occurred over the previous two decades. In addition,
teenagers are more likely to use contraceptives at first
intercourse, especially condoms. About 12 percent of all
teenagers using contraception and one quarter of black
teenagers are using long-lasting hormonal methods including
injectable and implant contraceptives. These changes in
contraceptive use are probably important factors in the decline
in birth rates for second births to teenagers who are already
mothers (figure 5). The increases in contraceptive use reported
for teenagers are also found for older women. Also a factor for
black women in their late twenties and older is the continued
high rates of voluntary female sterilization.
Summary
I hope that my testimony has reinforced the four major
points I made when I began. First, nonmarital births rose
dramatically from 1940 to 1990, but have since stabilized with
a decline since 1994. Second, teens do not account for all
nonmarital births; two thirds are to women aged 20 and older.
Third, teen birth rates declined considerably since 1991,
nationally and across all states, but most teen mothers are not
married. Fourth, nonmarital births and teen births have fallen
for all population groups, but most steeply for black women.
Thank you for the opportunity to present these data. I
would be pleased to answer any questions you may have.
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Chairman Johnson of Connecticut. Mr. Zill--Dr. Zill.
STATEMENT OF NICHOLAS ZILL, PH.D., VICE PRESIDENT AND DIRECTOR,
CHILD AND FAMILY STUDIES, WESTAT, ROCKVILLE, MARYLAND
Dr. Zill. Good morning. My name is Nicholas Zill. I am the
drector of the Child and Family Study area at Westat, a survey
research firm in the Washington area. Over the last 24 years, I
have been conducting national surveys of the health and
learning of our Nation's children and working to develop
statistical indicators of family and child well-being.
Three years ago, I had the privilege of testifying before
this committee on unmarried parenthood as a risk factor for
children. Today, I come before you to report that significant
progress has been made in the last few years in slowing or
reversing the explosive growth in unmarried childbearing that
had been proceeding unchecked since the mid-1960s. In the
Nation as a whole and in all major racial and ethnic groups,
the proportions of children born to unmarried parents in 1997
were no different or only marginally higher than the comparable
proportions that I previously reported for 1993.
There have also been significant changes in the life
circumstances of children who are growing up with unmarried
mothers. More of these children have mothers who are employed
and working full-time, rather than being welfare dependent.
More have fathers who are paying at least some child support.
As a result, the average income of these families has
increased, and the proportion living in poverty has declined.
Despite these real and meaningful gains, the picture is far
from rosy. Although rates of unmarried childbirth have stopped
increasing, they are still at levels that are three times
higher than they were in 1970. This year, nearly one in three
children born in the United States will be born outside of
marriage. Much more change is needed before the proportion
returns to the relatively low levels that it had been at for
most of this Nation's history.
There is a great deal of variation in the unmarried birth
ratio across racial and ethnic groups, as you can see in figure
1 in my written testimony. Those groups that have been least
successful economically in our society exhibit much higher
unmarried birth ratios than groups that have been relatively
successful. Among African Americans, for example, more than 2
out of 3 births are to unmarried parents; among Mexican
Americans, 4 in 10. Among Japanese Americans, by contrast, 1 in
10 births is to an unmarried mother. Efforts to increase
educational and economic opportunity for all minority groups
are being thwarted by continued high rates of unmarried
childbearing.
Much more change is needed, as well, before unmarried
parents could be deemed to be living up to their financial
responsibilities to their offspring. I want to give you some of
the numbers that illustrate some of the recent favorable
trends, however, in the circumstances of children living with
never-married mothers.
In 1993, less than half of the children living with never-
married mothers, 49 percent, had mothers who were in the labor
force. By 1998, that proportion had grown to 69 percent, which
is a 41 percent increase. The fraction of these children with
mothers who worked full-time grew from 28 percent in 1993 to 42
percent in 1998. That is a 50 percent rise.
The proportion receiving some support from the fathers of
their children increased from 15 percent in 1989 to 21 percent
in 1995, an improvement of more than a third. The median family
income of children with never-married mothers grew from $9,292
in 1992 to $12,064 in 1997, an increase of 30 percent. The
proportion living in families with incomes below the official
poverty line improved from 66 percent in 1992 to 58 percent in
1997, which is a 12 percent decline.
Despite these improvements, the economic circumstances of
children living with never-married mothers remain dismal. This
is so even in comparison to the situation of children living
with divorced mothers, but especially in contrast to the far
more favorable circumstances of children living with two
parents. In my written testimony, I have made some detailed
contrasts, which you can see in Table 1.
Just to give you a few illustrations, 42 percent of
children of never-married mothers worked full-time in 1998,
whereas the same was true of 63 percent of children of divorced
mothers. Fifty-one percent of divorced fathers contributed to
the child support of their children versus 21 percent of never-
married fathers. The poverty rates, respectively, were 58
percent for children with never-married mothers, 36 percent for
those with divorced mothers and only 9 percent for those in
two-parent families.
The elaborate child support enforcement mechanisms that
have been put into place in recent years are working fairly
well for middle-class divorced parents who have conventional
occupations. They are working much less well for unmarried
parents, many of whom do not have a regular job or work only in
the underground economy. Better ways must be devised to get
unmarried parents who live apart from their children to work
and contribute regularly to the support of the children they
have fathered. By making sure that the action of fathering a
child has real consequences for the young men involved, that
they cannot simply walk away from their responsibilities with
impunity--and 79 percent of fathers are doing that right now,
are not providing any child support for their children--we will
not only be improving the lot of the children involved, we will
also be helping to reduce the frequency of unmarried conception
and childbirth in the future.
In conclusion, I would urge this committee to track and be
concerned not only about the rate and ratio of unmarried
births, but also about indicators of the life circumstances of
children born and being raised outside of marriage, indicators
such as those I have presented in this testimony.
I request that my written statement and the accompanying
figures be placed in the record. Thank you.
[The prepared statement follows:]
Statement of Nicholas Zill, Ph.D., Vice President and Director, Child
and Family Studies, Westat, Rockville, Maryland
Good morning. My name is Nicholas Zill. I am the Director
of Child and Family Studies at Westat, a survey research firm
in the Washington area. For the last 24 years, I have been
conducting large-scale studies of the health and learning of
our nation's children and working to develop statistical
indicators of family and child well-being.
Three years ago, I had the privilege of testifying before
this committee on unmarried parenthood as a risk factor for
children. I presented evidence showing that children born
outside of marriage have a substantially greater risk of being
raised in poverty than children born to married parents. They
also have more chance of suffering illnesses and injuries,
experiencing difficulties in school, becoming victims of crime,
and growing up to engage in delinquent behavior or become teen
parents themselves.
It is not just the simple fact of birth outside of marriage
that produces these increased risks, but a cluster of negative
circumstances that usually accompanies unmarried parenthood in
the United States. Related risk factors include parental
immaturity and low parent education levels.
Today I come before you to report that significant progress
has been made in the last few years in slowing or reversing the
explosive growth in unmarried childbearing that had been
proceeding unchecked since the mid-1960s. For the nation as a
whole, and in all major racial and ethnic groups, the
proportions of children born to unmarried parents in 1997 were
no different or only marginally higher than the comparable
proportions that I previously reported for 1993.
There have also been significant changes in the life
circumstances of children who are growing up with unmarried
mothers. More of these children have mothers who are employed
and working full time rather than being welfare dependent. More
have fathers who are paying at least some child support. As a
result, the average income of these families has increased and
the proportion living in poverty has declined.
Despite these real and meaningful gains, the picture is far
from rosy. Although rates of unmarried childbirth have stopped
increasing, they are still at levels that are three or more
times higher than they were in 1970. This year, nearly one in
three children born in the United States will be born outside
of marriage. Much more change is needed before the proportion
returns to the relatively low levels it had been at for most of
this nation's history.
There is a great deal of variation in the unmarried birth
ratio across racial and ethnic groups, with those groups that
have been least successful economically in our society
exhibiting much higher unmarried birth ratios than ethnic
groups that have been more successful. Among African-Americans,
for example, more than two out of three births are to unmarried
parents. Among Mexican-Americans, four in ten. Among Japanese-
Americans, by contrast, one in ten births is to an unmarried
mother. (See Figure 1 for further examples.) Efforts to
increase educational and economic opportunity for all minority
groups are being thwarted by continued high rates of unmarried
childbearing.
Much more change is needed as well before most unmarried
parents could be deemed to be living up to their financial
responsibilities to their offspring and before the economic
circumstances of children living with unmarried mothers could
be described as even adequate. I would argue that changes such
as increased child support from unmarried fathers and increased
employment by unmarried fathers and mothers would not only
improve the lives of their children, they would also have a
beneficial feedback effect in reducing the numbers of children
born outside of marriage in the future.
Here are some numbers that illustrate recent favorable
changes that have occurred in the life circumstances of
children born and being raised outside of marriage:
In 1993, less than half of children living with
never-married mothers--49 percent--had mothers who were in the
labor force. By 1998, that proportion had grown to 69 percent,
a 41-percent increase.
The fraction of these children with mothers who
worked full time grew from 28 percent in 1993 to 42 percent in
1998, a 50-percent rise.
Although the unemployment rate among these mothers
has remained very high, it has eased slightly, going from 21
percent in 1993 to 17 percent in 1998.
The proportion of never-married mothers with
dependent children who received some child support payments
from the fathers of these children during the year increased
from 15 percent in 1992 to 21 percent in 1995, an improvement
of more than one third.
The median family income of children with never-
married mothers grew from $9,292 per year in 1992 to $12,064 in
1997, an increase of 30 percent (not adjusted for inflation).
The proportion living in families with incomes
below the official poverty line improved from 66 percent in
1992 to 58 percent in 1997, a 12-percent decline.
Despite the improvements just enumerated, the economic
circumstances of children living with never married mothers
remain dismal. This is so even in comparison to the situation
of children living with divorced mothers, but especially in
contrast to the far more favorable circumstances of children
living with two parents. Here are some of the relevant
comparisons:
Whereas 69 percent of children living with never
married mothers had mothers who were in the labor force in
1998, the same was true of 81 percent of children living with
divorced mothers. Among children living with two parents, 88
percent had at least one parent in the labor force, and 60
percent had both parents employed.
Whereas 42 percent of children of never-married
mothers had mothers who worked full time, the same was true of
63 percent of children with divorced mothers.
While 17 percent of children with never-married
mothers had mothers who were looking for work but unable to
find it in 1998, the same was true of less than 7 percent of
children of divorced mothers, and only 3.4 percent of children
in two-parent families.
The proportion of divorced mothers living with
dependent children who received child support from the fathers
of those children in 1995 was considerably higher than the
comparable proportion for never married mothers: 51 percent
versus 21 percent. The average amount of annual child support
received by those who received any support was also
considerably higher among divorced than among never-married
mothers: $3,990 (or about $333 per month) versus $2,271 (or
about $189 per month).
Whereas the median family income for children with
never-married mothers was $12,064 in 1997, it was $21,316 for
children with divorced mothers, and $52,553 for children in
two-parent families.
The respective poverty rates for children in 1997
were 58 percent for those with never-married mothers, 36
percent for those with divorced mothers, and 9 percent for
those in two-parent families.
The way to reduce welfare dependency and combat childhood
poverty is not to hold unrealistic expectations about increased
educational attainment among unmarried mothers and fathers.
Every parent cannot be a college graduate, nor should we expect
that everyone needs to be in order to make ends meet. The way
to accomplish both goals is to insure that all men and women
who bring children into the world work steadily and make
regular and meaningful contributions to the financial support
of their children. This should be the case whether the parents
are married or unmarried.
The elaborate child support enforcement mechanisms that
have been put into place in recent years are working fairly
well for middle-class divorced parents who have conventional
occupations. They are working much less well for unmarried
parents, many of whom do not have a regular job or work only in
the underground economy. Better ways must be devised to get
unmarried parents who live apart from their children to work
and contribute regularly to the support of the children they
have fathered. By making sure that the action of fathering a
child has real consequences for the young men involved--that
they cannot simply walk away from their responsibilities with
impunity--we will not only be improving the lot of the children
involved. We will also be helping to reduce the frequency of
unmarried conception and childbirth in the future.
In conclusion, I would urge this committee to track and be
concerned not only about the rate and ratio of unmarried births
in the U.S., but also about indicators of the life
circumstances of children born and being raised outside of
marriage, indicators such as those presented in this testimony.
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Chairman Johnson of Connecticut. Thank you. We will place
your entire statements in the record for both witnesses.
To what extent is this decline in nonmarital births related
to demographics, a decline in the number of women of
childbearing age?
Ms. Ventura. That is an issue. The childbearing age
population is getting older, and older women are less likely to
have nonmarital births; but even so, the rates have declined
for women in all age groups. So that is the other part of it.
The long-term increases were for all age groups, and the recent
declines have been drawn from most age groups.
Chairman Johnson of Connecticut. How much do we know about
how much this decline is related to abstinence and how much is
related to contraceptive use?
Ms. Ventura. The data from the National Survey of Family
Growth and the CDC Youth Risk Behavior Survey and also the
National Survey of Adolescent Males have all shown that there
has been a decline in sexual activity among teenagers in the
1990s, and among those who are sexually active, an increase in
contraceptive use at first intercourse. For the really high-
risk teenagers, those who have already had a baby, there has
been an increase in the proportion of who are using the long-
lasting hormonal methods.
We have not been able to sort out exactly how much of the
decline is accounted for by abstinence and how much is
accounted for by changes in contraceptive use. I think they are
both important, but we haven't been able to apportion them
precisely.
Chairman Johnson of Connecticut. Would you have any comment
on that, Dr. Zill, particularly on this issue of the specific
role of abstinence programs and the change as it resulted and
the sort of commonness of that discussion? I mean, years ago
there was no talk of abstinence at all, during the 1970s and
1980s, and now there is; and there are programs out there that
are planting this idea more broadly where teenagers can hear
it. What evidence do we have that this is being heard and
thought about by kids?
Dr. Zill. Well, I would point to a couple of things.
First, as far as demographics are concerned, the changing
ethnic and racial composition of our population would actually
lead you to expect more nonmarital births. So I think the
leveling-off is particularly impressive, given that. I think
you also have to think, though, in terms of the future
prospects and the calculations--the unconscious calculations--
that go on in young people's minds. I think many minority
teenagers have seen the very bad example of their parents who
became crack addicts, who had teen births, who wound up in
poverty and welfare dependence, often in institutions.
And I think some of what is going on in terms of refraining
from sexual activity, as well as using contraceptives, is that
the prospects for young women, particularly with our Nation's
effort to increase educational and economic opportunities, are
better. So more of them are saying, I don't want to get into
the losing pattern that I saw my mother and my aunts develop. I
think we have to focus on that rather than simply lecturing to
children about sexual behavior.
There is still a great deal of sexual activity in our
society, and the mass media encourage it all the time. There is
always the message out there that sex has no consequences, it
is just fun, don't worry about it. It is still very cool for a
lot of young men to father children without living up to the
consequences; I think we have to change some of that. But I
think we also have to think in terms of the real life prospects
of the young people involved and make sure that they have
better opportunities than becoming a welfare mother or becoming
a teen mother, and I think that has to be part of it, rather
than just thinking of these techniques of contraception or
thinking of abstinence apart from that larger socioeconomic
picture.
Chairman Johnson of Connecticut. I think there is
increasing, at least anecdotal, evidence that the kids, that
the mothers who are leaving welfare are impressed and tend to
be more interested in school and begin to see their
opportunities as different. I can remember going to
kindergartners and asking kids what they wanted to do when they
grew up and having them actually answer, I am going to be on
welfare. So I think--I don't know to what extent sort of that
opening of opportunities is influencing the birthrate and to
what extent the more public conversation about abstinence is
influencing it, the greater availability of better
contraceptive options is influencing it.
But I do think the talk about abstinence, and I do see my--
the Governor of Texas' comments in quite a different light than
my colleague or than Mr. Cohen of the Washington Post. I think
it is healthy that he is visiting abstinence programs. I think
it is important that the conversation get better balanced about
the benefits of abstinence, particularly in an era of
extraordinarily dangerous sexually transmitted diseases.
And so I think we need to rebalance the message, and the
abstinence programs are a part of doing that, with the delay in
marriage rates. As to whether we can or want to influence
adults beyond discouraging them from having children without
the support of the whole family is a different question, but I
do think the abstinence programs are important.
So I appreciate your testimony today.
Mr. Cardin.
Mr. Cardin. Thank you, Madam Chair.
Is there any evidence that sexual activity among teenagers
has declined?
Ms. Ventura. Yes.
Mr. Cardin. Give me some specifics. What type of
information do we have? How do we know that?
Ms. Ventura. We have information from the National Survey
of Family Growth, which is a survey of women in the
childbearing ages. We have information from the Youth Risk
Behavior Survey that CDC operates, and also from the----
Mr. Cardin. And how is that information presented?
Ms. Ventura. Well, they have published the findings through
1997.
Mr. Cardin. And what age groups--is it all age groups?
Ms. Ventura. The National Survey of Family Growth is for
all age groups. The other two surveys are just for teenagers or
the school-age population. The published results have shown
that for teenagers there has been a decline in sexual activity.
Mr. Cardin. And do we know the percentage decline?
Ms. Ventura. It is modest.
Mr. Cardin. Is it equal to the decline in pregnancies?
Ms. Ventura. No.
Mr. Cardin. So we have had a larger decline in pregnancies
than we have had in sexual activity decline, but we have seen a
decline?
Ms. Ventura. Right.
Mr. Cardin. So, therefore, in following up Mrs. Johnson's
question, abstinence to a certain degree has--whatever policies
we have used, there has been a decline in sexual activity, but
also contraceptives would at least be responsible for some of
the decline in pregnancies in the last 6 or 8 years----
Ms. Ventura. Yes.
Mr. Cardin [continuing]. The combination of the two has
been successful, at least in reducing the growth rate, and in
some cases, actually declining the amount of teenage
pregnancies.
Ms. Ventura. Yes.
Mr. Cardin. Dr. Zill, you mentioned a very interesting
point that I hadn't thought about. I thought about it in
reverse, and that is, if the child is born to a teenage mother,
is that child more likely to be a teenage mom?
Dr. Zill. There is some evidence of that.
Mr. Cardin. The answer is--I thought it would be yes.
Dr. Zill. It is.
Mr. Cardin. But then you are saying that you see your
parent, as an example, as very unsuccessful economically or
ending up in prison or ending up with serious abuse problems.
You don't want that to happen to yourself, therefore, don't go
down the same path; or you don't want to see it happen to your
child, so don't become pregnant.
Dr. Zill. Well, it is like the children of alcoholics, some
of them become alcoholics while others become teetotalers.
There is something of a bimodal distribution.
Mr. Cardin. But your first--we know that if you live in
poverty, you are more likely to become a teenage parent. We
know the problem. I guess we don't know why--it seems--why do
we have teenage pregnancies? What are the reasons? I mean, you
are giving us some of the statistical information.
Dr. Zill. A lot of the women who become teenage mothers are
academic failures. They don't have many prospects in front of
them. They don't see a bright future in their schools or in
their occupations. The examples in their neighborhood, as Mrs.
Johnson said, most of them are welfare mothers, and many of
them are fathers who don't support their kids. So in their
calculations, in many instances, welfare motherhood seemed like
a pretty good opportunity to at least have some sense of an
adult role and respect from others.
Mr. Cardin. I have heard that explanation given before,
some degree of accomplishment, have a child.
Dr. Zill. Right.
Mr. Cardin. That is still prevalent today from what you
are----
Dr. Zill. Well, I think you can see that even in the inner
city, that the students who are doing well or who have sports
scholarships in front of them are much less likely to become
pregnant. Also, those involved in meaningful activities, like
the school band, we found in some research we did, were less
likely to have teen pregnancies. The important thing is some
sort of positive involvement, some sort of path that goes away
from motherhood as the principal accomplishment.
Mr. Cardin. Have there been any studies done as to the
impact that sex education programs have had in our schools on
teenage pregnancies? Has there been any effort made to try to
equate the exposure of children to quality sex education
curriculum in schools and what impact that has had on teenage
pregnancy?
Dr. Zill. There has been some. The evidence I know about is
not very encouraging. I think the stronger evidence is that if
there is value-based instruction for children and if the family
supports it or if important peers support it, then there is
likely to be an effect. But value-neutral sex education is not
effective.
Mr. Cardin. And what do you base that on?
Dr. Zill. The evidence that is out there.
Mr. Cardin. Well, I think it would be very useful if you
can make that available to our committee. I would welcome the
opportunity of looking at and exploring the methodology used on
these evaluations.
I think we all want to achieve the results of less teenage
pregnancies, and we want to deal with the issues that you have
brought forward. It is difficult to deal with this in the
abstract, and there are a lot of competing philosophies around
this place, and if we are ever going to be able to get any
degree of consensus on government policy in this area, then we
are going to have some degree of confidence that we are going
to enact something that really will deal with the underlying
problem.
My own thought is that good programs in schools dealing
with young people who may not have the best role model at home,
or the best example at home, could be a very helpful part of
the overall equation here to reduce the teenage pregnancy rate;
but how that is structured and who has the most effective
program and whether we are sharing that information and whether
we have a national commitment to that is something I am not
certain about.
So I would appreciate it if you would make available to us
the specifics of the studies that you are referring to and, if
possible, the methodology that was used in those surveys.
Thank you, Madam Chair.
Chairman Johnson of Connecticut. I would like to just
follow up on two questions.
Dr. Zill, you mentioned that 51 percent of divorced
mothers--Dr. Zill, sorry--that 51 percent of divorced parents
received child support payments and even after all the effort
we have made, only 21 percent of nonmarried fathers contribute.
Now, we are thinking about a fatherhood initiative. Who are
we going to reach and what about that great majority of the
fathers of the unmarried mothers' babies that we are not even
reaching through child support enforcement and paternity
determination requirements? I mean, that seems to me astounding
that given paternity determination requirements to be eligible
for the welfare system, we are still not--is it that we are not
collecting from more than 20 percent? We have reached some of
the others, but they have no money? And are 80 percent really
beyond our communications network?
Dr. Zill. Well, I think some of these changes are just
being instituted now. So it is going to take a while for them
to really work themselves out. It is not an easy problem
because, as you said, many of the young men don't have the kind
of jobs where you can garnish their wages easily. Some of them
may be in prison, some of them may be working in the
underground economy. But we really have to make more of an
effort.
I feel that a lot of the child support mechanisms have gone
to the easy place, the way a drunk looks for the keys where the
light is. We are doing a great job with these middle-class
fathers where we can garnish their wages. In fact, we are
probably being overenthusiastic with them. But with the tougher
cases, we are not doing a good job.
I think there is a lot of interesting research going on now
with unmarried fathers and I think we can learn a lot from
that. Rebecca Maynard, who is going to testify later, could
probably provide some concrete suggestions in terms of programs
that can be effective. But currently 79 percent of the
unmarried fathers have no consequences of fatherhood. And so
much of welfare reform has focused on the mothers; we really
need to put the responsibility on the fathers as well.
For example, right now, a lot of people are saying, well,
we need to give welfare mothers enough education to support
their children--college educations. Well, everybody is not
going to become a college graduate. But even at relatively low-
paying jobs, if both the mother and the father cooperate, it is
possible to get out of poverty; and we have to have more of
both parents helping support their children, even if they are
unmarried.
Chairman Johnson of Connecticut. Well, we did make--the
Ways and Means Committee made dramatic changes in the support
for higher education, and frankly, anybody working now can go
get a community college degree, absolutely for free, through
tax cuts. So to do that, you have to have a way to share at
daycare and things like that, and that means cooperation
between both parents. But we are going to be doing a fatherhood
initiative, and any thoughts you have on how we reach out, we
would be interested.
And one last question, what do we know about abortion? How
consistent and of what quality is the abortion data from
States, and has there been any increase in abortion since
welfare reform?
Ms. Ventura. Actually, the National Center for Health
Statistics doesn't collect abortion data, but I can tell you
briefly what I know about it.
The States vary in completeness in the reporting of
abortion. Although it is reported in all States, the coverage
varies dramatically. The States provide information on
abortions to the CDC in Atlanta, that is, tabulated data. It is
not like the National Vital Statistics System where each
individual record is reported, so there is not the same
oversight. It is not the same kind of relationship between the
Federal and the State governments to provide this data.
From what we see, the abortion rates and the ratios and
percentages are all declining. They have been declining for a
number of years actually, even longer than the teen pregnancy
rates have been going down.
Chairman Johnson of Connecticut. Well, thank you very much
for your testimony. We appreciate it and thank you for being
with us.
Let's see, the next panel is Dr. Richard Nathan, director
of the Rockefeller Institute of Government in Albany; Robert
Rector, a senior policy analyst for the Heritage Foundation;
Isabel Sawhill, senior fellow, Economic Studies, Brookings
Institution; Pat Funderburk Ware, president and chief executive
officer of PFW Consultants; and Cory Richards, vice president
for Public Policy, Alan Guttmacher Institute.
Welcome.
Richard Nathan, would you begin, please.
STATEMENT OF RICHARD P. NATHAN, DIRECTOR, NELSON A. ROCKEFELLER
INSTITUTE OF GOVERNMENT, ALBANY, NEW YORK
Mr. Nathan. Thank you very much, Madam Chair. The emphasis
of our research is on implementation, what is happening in
State and local governments and in social program bureaucracies
as welfare reforms are implemented; and I will just highlight
the double-spaced part of my testimony.
The first report of our 20-State implementation study
showed that the governors and State legislatures have adopted
welfare reforms that strongly signal the importance of the work
objective.
We do not, however, find similar widespread policy or
administrative support for the act's anti-reproduction goals.
Legislative proposals and often tentative administrative policy
initiatives to change sexual behavior have been advanced in
some States, but often they are dropped, watered down or
deemphasized at the front line by the workers, which is
critical in this area because this issue elicits controversial
attitudes that probably can't generate statewide support in any
State.
The essential challenge involves disagreements about, as
you have discussed, the methods for preventing teen pregnancy
and out-of-wedlock births. The basic divide is between
abstinence and a distribution of contraceptives.
In the next section of my testimony, on page 2, I talk
about defining ``deviance up,'' to take a line and reverse it
from Senator Moynihan. This is a time when social policy is
changing values in the education area, in the welfare area and
in the housing area--all across the board. The Personal
Responsibility Act is aptly named.
In the work area, the national consensus has been loud and
clear for a long time, but in the other major area, where the
signaling of the 1996 Act is even stronger, the picture is less
clear.
The next section of my testimony lists four lessons from
our management research in the States, first of all, about how
devolution is increasing dramatically. I have been in this
field a long time. I am really impressed by this.
The second point is that the real story of devolution is
second order and tertiary devolution down to local levels.
The third point is that in the super-sensitive area of
pregnancy prevention, this push to the local level is
particularly powerful. It is like a hot potato: Pass it along
for somebody else to deal with it according to the values that
prevail in local communities.
And the fourth point from our research is that the main
bureaucracies involved (the work and welfare bureaucracies)
don't connect easily or often with health bureaucracies and
family planning clinics, and that is a big challenge.
The next part of my testimony deals with this problem as an
opportunity to make linkages. We are doing work at the
Rockefeller Institute with the General Accounting Office on
what we call, as I say on page 5 of my testimony,
``connectivity.'' The key to welfare reform is building systems
that connect social programs, food stamps, Medicaid and many
social services. It is not just a matter of knowing what we do.
It is also a matter of doing what we do. Information technology
now provides the power to make these connections at the front
lines.
Some States are working hard on this. Teen pregnancy
prevention and prevention of out-of-wedlock births, however, is
usually not on this screen, as I say in the testimony, either
figuratively or literally.
Skipping along in the testimony, the highlight and central
point of our research is that signaling matters, that while
administrative procedures may not be changing materially and in
deep and substantial ways because of uncertainty about this
policy area, the signaling about work and time limits on
welfare, although I can't prove it, I believe has contributed
materially to the declines that we just heard about in teen
births and in out-of-wedlock births. Other factors, for
example, fear of AIDS and technology (new technology for birth
control), obviously also contribute, and it is impossible to
know what is causing what.
The last line of my testimony brings out what I think is
the essential dilemma of this hearing. Last week we saw the new
Austin Powers movie, ``The Spy Who Shagged Me.'' I looked up
``shag'' in my dictionary. It is what baseball players do in
the outfield when they are practicing. Lots of people were
there the afternoon we went to the movie with children--10, 11,
12 years old. The popular culture incessantly signals a set of
permissive values about sexual behavior, while at the same time
the political culture gives a decidedly different and very
strong signal about abstinence and family integrity; and that
is why, as we say, the administrative challenge in this area is
such a big and very complicated one.
I thank you very much for the chance to present testimony.
I ask that the whole statement be put in the record.
Chairman Johnson of Connecticut. Thank you. All the
statements will be put in the record in their entirety, and I
would just like to comment, Mr. Nathan, I did very much enjoy
your report on your 20-State study and found it very, very
helpful, and have given it to my State people responsible for
improving the functioning of our State program as that lack of
connectivity is still a problem.
[The prepared statement follows:]
Statement of Richard P. Nathan, Director, Nelson A. Rockefeller
Institute of Government, Albany, New York
Preventing Teen and Out-of-Wedlock Births Through Welfare Reform
The Personal Responsibility and Work Opportunity
Reconciliation Act of 1996 (PWORA) was intended to discourage
welfare recipiency, promote work and marriage, and reduce out-
of-wedlock births and teen pregnancies. The first report on the
20-state implementation study of the Act conducted by the
Rockefeller Institute of Government shows that governors and
state legislators have adopted welfare reforms that strongly
signal the importance of the first of these two objectives--
work. Work-oriented welfare reforms often have been undertaken
enthusiastically by bipartisan political coalitions.\1\
---------------------------------------------------------------------------
\1\ Nathan, Richard P., and Thomas L. Gais. Implementing the
Personal Responsibility Act of 1996: A First Look (Albany, NY: The
Nelson A. Rockefeller Institute of Government, 1999). Copies available
from the Rockefeller Institute call Michele Charbonneau (518-443-5258).
---------------------------------------------------------------------------
We did not however find similar widespread policy or
administrative support for the Act's anti-reproduction goals.
Legislative proposals and often tentative administrative policy
initiatives to change sexual behavior have been advanced in
some states, but often they were dropped, watered down, or de-
emphasized before state welfare reform legislation was passed
or broad executive orders promulgated. This issue elicits
controversial attitudes and proposals that probably could not
generate broad support in any state. In Mississippi, for
example, the state's original welfare reform bill in 1992
included provisions calling for Norplant implants for AFDC
recipients with four or more children and a thousand dollar
``reward'' to women who married and left the rolls, but these
components were dropped from the bill before it was enacted
into law (Mississippi Field Research Report, 1998).
The essential challenge in this policy area involves
disagreements about the methods for preventing teen pregnancy
and out-of-wedlock births. The basic divide is between
abstinence and the distribution of contraceptives. In Utah,
front-line workers are not allowed to discuss birth-control
options with welfare clients. In Washington State, field
reports indicate that front-line workers do not feel it is
appropriate to discuss such personal issues with clients, even
though state policy is permissive in this respect. One New York
City official told our field researcher, ``Ninety percent of
our workers are themselves single parents and identify on that
point with their clients'' (New York State Field Research
Report, 1998).
In the world of welfare, this subject tends to be off
limits. The political problem is the obvious one: While there
may be a consensus on the wisdom and desirability of preventing
pregnancies among teens and out-of-wedlock births among the
TANF-eligible population, there is not a consensus on how to do
it. Despite this and although I can't prove it, I believe the
signaling changes of welfare reform are having an impact in
reducing teen and out-of-wedlock births. This is more a result
of policy than administrative changes, but the latter are
occurring. There is increasing awareness of opportunities,
especially at the local level, for linking job and family
policies as part of the broad national effort to ``end welfare
as we know it.''
Defining Deviance Up
In the U.S., there is a view--a wrong headed one--that
governments cannot influence social values and change cultural
attitudes. In fact and completely to the contrary, governments
do their most important work when they seek to influence social
values. The current period is a perfect example of a time when
governments--national, state, and local--turning around a
phrase Senator Moynihan likes to use--are hard at work trying
to define deviance up. The national movement to promote
competition in education by raising school standards through
student testing and the introduction of charter schools and
vouchers has a major analog in the welfare area in the
powerfully stated twin goals of the 1996 national welfare
reform act to promote work and discourage teen pregnancy and
out-of-wedlock births. Similar policies that reflect the goals
of the 1996 welfare reform act are embodied in the Federal
Housing Act of 1998.
The Personal Responsibility Act is aptly named. The Act has
generated efforts to inculcate personal-responsibility values
in government that I believe over the long haul will be viewed
as part of a cultural shift in America rivaling the equal and
opposite cultural shift to personal-permissiveness values in
the mid-1960s.
Government can do things that have broad citizen support.
For welfare policy in America, signals have changed. This is
certainly the case of the work-first goal of the 1996 law,
which has broad and deep citizen support. In this area, the
national consensus has been loud and clear for a long time. But
in the other major area where the signaling of the 1996
Personal Responsibility Act is even stronger than in the work
area, the picture is less clear.
Lessons from the Implementation Research
The Rockefeller Institute 20-state study of the
implementation of the 1996 Personal Responsibility Act provides
important lessons that apply to the goal of reducing teen
pregnancy and out-of-wedlock births:
First, we found a definite, strong move to
devolution for domestic policy, one that applies broadly to
welfare, employment programs, and social services related to
employment.
Second, we found extensive second-order and
tertiary devolution-- that is, the assignment of increased
responsibilities for devising strategies and setting up systems
to combat family dependency to local governments, local offices
of state agencies, and private groups (often nonprofit
organizations).
Third, in the super-sensitive area of pregnancy
prevention, this push to localize and decentralize is
especially powerful. A November 1998 report from the GAO
reached a similar conclusion.\2\ This political hot potato is
regularly tossed to local leaders and groups to handle as they
so choose because the values and attitudes involved are so
diverse in the country. In liberal communities, providing
contraceptives and even abortions is accepted. In others, they
are a source of great friction.
---------------------------------------------------------------------------
\2\ The GAO report stated: ``States generally gave localities the
flexibility to choose the type and mix of programs they wanted to put
in place.'' See: ``Teen Pregnancy: State and Federal Efforts to
Implement Prevention Programs and Measure Their Effectiveness.''
(Washington, D.C.: U.S. General Accounting Office, GAO/HEHS-99-4)
November 1998, p. 3.
---------------------------------------------------------------------------
Fourth, the institutions and agencies responsible
for preventing teen pregnancy and out-of-wedlock births do not
connect well or easily with welfare and employment
bureaucracies, even in communities where liberal attitudes
prevail on pregnancy prevention. Welfare and employment
bureaucracies are increasingly linked all over the country,
though their relations are often tense. However, an important
and pervasive finding from our 20-state field data is that
neither of these two major types of agencies--welfare or
employment agencies--have close ties with health agencies or
local public health clinics, particularly family planning
clinics.
I believe this problem--the problem of the lack of
connections between welfare and employment and health agencies
and operations--provides an opportunity. The opportunity is for
leaders and groups committed to teen pregnancy prevention and
the prevention of out-of-wedlock births, regardless of the
approach they favor, to forge linkages to welfare and
employment policies and bureaucracies. Of course, saying that
forging stronger linkages are the key as next steps is a lot
easier than taking such steps. However, in light of the fact
that a major purpose of the 1996 welfare reform act is to
prevent teen pregnancy and out-of-wedlock births, the clear and
present need is to do this to make such connections. Government
agencies, foundations, and private nonprofit organizations that
care about this policy objective would benefit by building
relationships at the ground level between health agencies and
welfare-job systems.
``Connectivity'' the Key
The new all-purpose, five-syllable word in our research on
welfare implementation is connectivity. Controversies have
arisen about connections among social programs as welfare
becomes ever more focused on jobs. The biggest controversies
have been about the effects of reductions in welfare rolls on
participation in the Food Stamp and Medicaid programs. This
connectivity idea, however, is even broader. It involves, not
only income-support for families, but also child care, health,
transportation, and a range of employment and family and
children's services to enhance family self-sufficiency. Looking
across the board, the lack of connectivity in the case of
pregnancy prevention is the most striking among all the areas
that could be keys to helping poor families become and remain
stable, healthy, and independent.
For the past two years the Rockefeller Institute of
Government and the U.S. General Accounting Office have
conducted a ``Working Seminar on Social Program Information
Systems,'' a permanent group that meets quarterly on the
mechanics of social program connectivity. The overarching
purpose of the working seminar is service integration. For
decades, people have talked about holistic strategies to
overcome the bureaucratic separation of social program
fiefdoms. Information technology now provides the power to make
these connections at the front lines. Some states are working
hard on this. Teen pregnancy prevention, however, usually is
not on this screen--either figuratively or literally.
Change has Occurred
Despite this finding that the pregnancy-prevention
objectives of the Personal Responsibility Act have so far had
relatively little effect on the behavior of welfare and job
bureaucracies, there are grounds for expecting personal
behavior in this area to change as a result of the Act, and
indeed I believe it is already changing. TANF-aided family
heads (most of them female, and many of them unmarried) face a
new reality of time-limited cash assistance and more serious
requirements for work and participation in work-search and
related activities. They have to participate in work-related
activities for fixed amounts of time under negotiated
``Personal Responsibility Agreements'' that states require be
signed before a TANF cash-assistance case can be opened. If
there is a noncustodial parent, usually a male, there is now a
new social dynamic: ``If he isn't required to do anything, why
should I be; why shouldn't he be responsible too?'' State
officials predict that this kind of attitude change and the
resentment evoked by time-limited cash assistance is already
affecting child-bearing behavior, and that this signaling
effect will increase.
The most prominent finding from our 20-state research on
the implementation of welfare reforms is precisely in this
area--that signaling matters. Teen births in the U.S. are the
highest in the industrialized world (twice as high as Great
Britain which ranked second). Actually, teen births are
declining now--and at an increasing rate.\3\ Overall, teen
births declined from 62.1 per 1,000 teens aged 15-19 in 1991 to
52.3 in 1997, the latest year for which we have data.\4\ In my
opinion, though I cannot prove it, stronger signaling in
welfare policy has contributed materially to this decline.
Other factors, too--fear of AIDS and new technology (notably
Depo-Provera)--have also contributed. But determining causality
in this super-sensitive policy area is impossible.
\3\ National Campaign to Prevent Teen Pregnancy. Whatever Happened
to Childhood? The Problem of Teen Pregnancy in the United States.
(Washington, D.C., 1997)
\4\ ``Preventing Teenage Pregnancy,'' HHS Fact Sheet (Washington,
D.C.: U.S. Department of Health and Human Services, April 29, 1999)
---------------------------------------------------------------------------
Note: Additional information on findings from the
Rockefeller Institute's Implementation Study of the Personal
Responsibility Act of 1996 is presented in the sections that
follow. I request that the full statement, including this
material, be printed in the hearing record.
State Responses
A November 1998, GAO report stated:
Teenage pregnancy and parenthood have unfortunate
consequences for society, teenage mothers, and the children
born to them. Teen mothers frequently do not complete high
school, have poor earnings, and have increased dependency on
the welfare system. A child born to a teen mother is more
likely to have a low birthweight and health problems, suffer
abuse, live in an inferior home environment, be poor, and be
less likely to succeed in school. Moreover, a child born to a
teen is more likely to become a teenage parent.\5\
---------------------------------------------------------------------------
\5\ GOA/HEHS-99-4, p. 1.
Given the clashes over values in this policy area, most
states have adopted indirect approaches to get at this
challenge. Changes in reproductive behavior tend to be treated
as expected side-effects of welfare reform policies. The
Rockefeller Institute's research team in Wisconsin put it this
---------------------------------------------------------------------------
way:
Certainly the architects of W-2 expect the program over time
to reduce non-marital births, mostly because mothers can no
longer receive cash assistance without working and because teen
parents must live in an adult-supervised setting to receive W-2
services or support. . . . But reduction in out-of-wedlock
pregnancies is a hoped-for by-product of W-2. . . . The program
has no components aimed exclusively at the issue, and W-2
agencies have no formal role in preventing out-of-wedlock
pregnancies. (Wisconsin Field Research Report, 1998; emphasis
added.)
Nine states in the Rockefeller Institute sample created
task forces on teen pregnancy prevention to deal with this
subject, a familiar tactic to put off action in sensitive,
controversial policy areas. While many aspects of this policy
area are controversial, some provisions of the 1996 welfare
reform legislation were rather quietly enacted, for example,
the requirements that teen mothers live at home or in an adult
supervised setting and that they stay in school.
Some states are trying to find a middle ground that is not
ideologically charged, an approach that offends neither
liberals nor conservatives. In West Virginia, for example,
there is a marriage incentive, a ten percent increase in the
monthly cash grant for two-parent families.\6\ The relative
popularity of family caps--twenty states now have them--
reflects the same purpose, i.e., to discourage the birth of
additional children without specifying how those births are to
be prevented. However, the politically attractive ambiguity of
this approach may not last. Recent studies of the effects of
family caps in New Jersey conducted by researchers at Rutgers
University suggest they may increase the incidence of
abortions, thus casting doubts on their political
acceptability.\7\
---------------------------------------------------------------------------
\6\ Levin Epstein, Jodie. State TANF Plans: Out-of-Wedlock and
Statutory Rape Provisions (Washington,. D.C.: Center for Law and Social
Policy, 1997)
\7\ Preston, Jennifer. ``With New Jersey Family Cap, Births Fall
and Abortion Rise.'' The New York Times, November 3, 1998.
---------------------------------------------------------------------------
``The Devolution is in the Details''
The Personal Responsibility Act complicates this value-
reconciliation challenge. It makes $250 million available over
five years for abstinence-only education programs to be
administered by the states. There is a detailed set of
regulations that must be followed to obtain this money. To be
funded, a program must:
1. Have as its exclusive purpose, teaching the social,
psychological, and health gains to be realized by abstaining
from sexual activity;
2. Teach that abstinence from sexual activity outside
marriage is the expected standard for all school-age children;
3. Teach that abstinence from sexual activity is the only
certain way to avoid out-of-wedlock pregnancy, sexually
transmitted diseases, and other associated health problems;
4. Teach that a mutually faithful monogamous relationship
in the context of marriage is the expected standard of human
sexual activity;
5. Teach that bearing children out of wedlock is likely to
have harmful consequences for the child, the child's parents,
and society;
6. Teach young people how to reject sexual advances and how
alcohol and drug use increases vulnerability to sexual
advances; and
7. Teach the importance of attaining self-sufficiency
before engaging in sexual activity.\8\
---------------------------------------------------------------------------
\8\ Haskins, Ron and Carol Statuto Bevan. ``Abstinence Education
Under Welfare Reform.'' In Abstinence Education Grants and Welfare
Reform Seminar web page. College Park, MD: University Maryland Welfare
Reform Academy, MD, 1997 (cited March 18, 1999). Available from http://
welfareacademy.org/pubs/main.htm
---------------------------------------------------------------------------
Most states have applied for and received their allotments
under this grant, but it is not clear that they will actually
use the money. Many state officials see the abstinence-only
program requirements as restrictive. They often do not
understand that TANF and MOE funds can also be used for other
pregnancy prevention approaches, such as family planning
counseling and the provision of contraception--that is, if
states choose to do so.\9\
---------------------------------------------------------------------------
\9\ Cohen, Marie. Tapping TANF: When and How Welfare Funds Can
Support Reproductive Health of Teen Parent Initiatives (Washington,
D.C.: Center for Law and Social Policy, April 1999).
See also an excellent analysis by Sawhill, Isabel V. Teen Pregnancy
Prevention: Welfare Reform's Missing Component (Washington, D.C.:
Brookings Institution, November 1998)
---------------------------------------------------------------------------
In the opinion of one state official, ``few projects will
be able to implement faithfully all components of the
definition in the law'' for abstinence-only programs. These
provisions, which require programs to teach that ``a mutually
faithful monogamous relationship in the context of marriage is
the expected standard of human sexual activity,'' have come
under scrutiny. State officials have told our field researchers
they are wary about setting aside money for abstinence
education because there are few studies that have linked
abstinence programs with the reduction in out-of-wedlock
births, although the U.S. Department of Health and Human
Services is currently supporting evaluations of abstinence-only
programs. Finally, to use abstinence-only funds, the state
needs to match every four federal dollars with three state
dollars. This matching requirement has proven difficult in some
states, in part because of the fear that the money used for
abstinence-only education competes or conflicts with funding
for other efforts to prevent teen pregnancies and out-of-
wedlock births.
Imposing requirements on the states to take steps to
prevent teen pregnancy is not new, though the emphasis on
abstinence is. In 1967, a law was enacted that required states
to offer family planning services ``in appropriate cases'' to
recipients of Aid to Families with Dependent Children (AFDC),
for the purpose of ``preventing or reducing the incidence of
births out of wedlock.'' The 1972 amendments explicitly
included sexually active minors in the definition of
``appropriate cases,'' and required that family planning
services be ``provided promptly'' to all who requested
them.\10\ The 1972 amendments also established a penalty if
states failed to comply with these requirements and provide
family planning services under Medicaid.\11\ The requirement
that AFDC clients be given information on family planning
remained on the books until it was repealed by the 1996 welfare
law.
---------------------------------------------------------------------------
\10\ Social Security Act, U.S. Code Annotated, Vol. 42 Secs.
602(a)(15)(A)(7) (1991).
\11\ Congressional and Administrative News, Legislative History,
1972, P.L. 92-603.
---------------------------------------------------------------------------
In addition to the abstinence-only emphasis in the 1996
Act, there are financial incentives to states tied to pregnancy
prevention. Two bonuses provided in the Act are to be given to
the states with the best performance. The first is the ``Bonus
to Reward High Performance States.'' The federal government
will reward states that best achieve the purposes set forth by
the Personal Responsibility Act (all of the goals, not just
those related to reproduction-reduction). Standards for this
bonus were established by the Secretary of the U.S. Department
of Health and Human Services in consultation with the National
Governor's Association and the American Public Welfare
Association, now the American Public Human Services
Association. One of the four goals on which performance bonuses
are based is the reduction of out-of-wedlock births. One
hundred million dollars per year is available for fiscal years
1999 and 2000.
In addition, a specific ``Bonus to Reward a Decrease in
Illegitimacy'' makes $100 million available, to be shared by
the five states that demonstrate the greatest reductions in
out-of-wedlock births. To qualify for the bonus, states must
demonstrate that the abortion rate is less than the FY 1995
level. It is important to note that both of these bonuses are
directed at the state's entire population, not only teens or
welfare recipients. These financial incentives, however, do not
appear to be promoting active policy initiatives and
administrative linkages between welfare and pregnancy
prevention.
Agency Interrelationships
The most significant institutional barrier to linking
pregnancy prevention and welfare/job programs is the fact that
pregnancy prevention programs are administered by health
agencies, local health clinics, family planning clinics, and
education departments--not welfare agencies. These agencies
typically concentrate their efforts in low-income communities,
but the missions and mechanisms involved do not directly tie
into welfare/job systems. Historically, pregnancy prevention
has been funded by the federal government under the Title X
Family Planning Program and public health and education laws to
achieve reductions in infant mortality or high school drop-out
rates for pregnant and parenting teens.
Because political disagreements over how to prevent teen
pregnancy--and thus how to make connections between programs
and program bureaucracies--are often less strong within some
communities than within whole states, most states have devolved
pregnancy prevention functions downwards in connection with the
1996 welfare reform act. Teen pregnancy prevention shows the
highest degree of second-order devolution of four basic
welfare-related service functions we examined. As Table 1
demonstrates, state agencies perform a relatively weak role in
managing pregnancy prevention activities when compared to their
roles in the administration of cash assistance or employment
and training services. In our research sample, fewer than half
of the state governments play an important role in delivering
pregnancy prevention services, and only two out of three state
governments exercise significant control over the
administrative design of such programs. One out of four states
have no important policy-making function in this area. Even
among the states that retain significant control over policy,
they often share that power with a wide variety of local
institutions, including local public health agencies, public
schools, and private nonprofit agencies.
This downward shift in program responsibility may reduce
some obstacles, but it creates others. Devolution down to
localities may allow for greater flexibility and community
involvement, but it can also cut down the budget for such
programs. For example, Ohio tried to create a teen-pregnancy
prevention bonus modeled after the federal one and was
unsuccessful. Despite the fact that there is a state-provided
incentive payment for the top performing counties in reducing
out-of-wedlock births, we were told that Hamilton County
(Cincinnati) ``downplayed the minimal amount of incentive money
. . . people interviewed were doubtful that the county could do
much to affect out-of-wedlock pregnancy and stressed that the
financial rewards are too small for the county to expend much
energy developing a program'' (Ohio Field Research Report,
1998).
Although site-specific actions in this policy area were not
found to be widespread, several field researchers did identify
cases of connectivity of welfare/job and teen pregnancy
prevention efforts.
In Washington State, welfare offices have family
planning nurses on staff. Eight of fifty welfare offices are
co-located with a family planning clinic. While funding has
increased for family planning under TANF, these connections are
not new.
Florida has mapped out a long-term strategy that
includes the implementation of a statewide protocol for the
referral of clients to family planning services. Eventually,
steps are to be taken so that family planning services are
integrated with work activities. Currently, some WAGES (``Work
and Gain Economic Self Sufficiency'') coalitions have
designated a staff member to coordinate pregnancy prevention
programs within their region.
Table 1. Devolution Of Pregnancy Prevention Program Functions to Local
Governments, Public Institutions, and Private Agencies
[Percent of states indicating that various institutions perform a
significant role in policy-making, administrative design, and service
delivery for pregnancy prevention, employment and training, and cash
assistance programs]
------------------------------------------------------------------------
Employment
Institution Pregnancy and Cash
Prevention Training Assistance
------------------------------------------------------------------------
Policy Making:
State government............... 74 100 100
Local government............... 27 26 21
Other public institutions...... 32 16 0
Statewide nonprofits........... 13 0 5
Local nonprofits............... 7 5 21
Administrative Design:
State government............... 63 95 95
Local government............... 21 32 37
Other public institutions...... 32 21 0
Statewide nonprofits........... 5 11 0
Local nonprofits............... 11 5 11
Service Delivery:
State government............... 42 74 58
Local government............... 53 47 37
Other public institutions...... 47 74 0
Statewide nonprofits........... 40 47 11
Local nonprofits............... 47 68 26
------------------------------------------------------------------------
Source: Field Research Reports, State Capacity Study, 1998.
Note: Data from nineteen states are included in the table. ``State
government'' includes local as well as central offices of state
agencies. ``Other public institutions'' includes school districts,
community colleges, public hospitals, ans so on.
In Georgia, as part of the eligibility process,
family members identified as needing information regarding
family planning are to be referred to services. The state plan
includes a list of personal responsibility requirements that
may, for example, include requiring family planning counseling
as well as participation in parenting classes for all teens
whether or not they are parents. Recent controversy appears to
have dampened the early enthusiasm for implementing this
requirement. Nevertheless, in Bibb County, Georgia, we found
that a family planning clinic is located just outside the
welfare office and workers make frequent referrals. In Fulton
County, Atlanta, one welfare office has on-site family planning
services.
These examples are more the exception than the rule. The
Rockefeller Institute is continuing, and in fact accentuating,
its local field observations, including a review of
implementation activities in the pregnancy-prevention policy
area for the second round of field research on the
implementation of welfare reforms.
Conclusion
At a conference last year at the American Enterprise
Institute on teen pregnancy prevention, Douglas Besherov, the
convenor, summarized the overall situation by citing ``deep
ambivalence'' in this policy area. Jason Turner, Commissioner
of the New York City Human Resources Administration, who also
spoke at this conference, agreed, saying there is ``lack of a
consensus'' not about whether to reduce teen pregnancy--but
how. The dilemma is real: The popular culture incessantly
signals a set of permissive values about sexual behavior, while
at the same time the political culture gives decidedly
different and very strong signals about sexual abstinence and
family integrity.
State Capacity Study Field Research Team Leaders
The Nelson A. Rockefeller Institute of Government
Arizona--John Stuart Hall, Arizona State University
California--Cristy A. Jensen, California State University
Florida--Robert E. Crew, Florida State University
Georgia--Michael J. Rich, Emory University
Kansas--Jocelyn M. Johnston, University of Kansas
Michigan--Carol S. Weissert, Michigan State University
Minnesota--Thomas F, Luce, University of Minnesota
Mississippi--David A. Breaux, Christopher M. Duncan, John C. Morris,
Denise Keller, Mississippi State University
Missouri--Rockefeller Institute Central Staff
New Jersey--Richard F. Roper, The Roper Group Consultants
New York--Sarah F. Liebschutz, SUNY Brockport Distinguished Service
Professor
North Carolina--Deil S. Wright, University of North Carolina
Ohio--Charles F, Adams, Jr., Ohio State University
Rhode Island--Thomas J. Anton, Brown University
Tennessee--John E. Gnuschke, University of Memphis
Texas--Christopher T. King, University of Texas at Austin
Utah--Gary C. Bryner, Brigham Young University
Washington--Betty Jane Narver, Janet Looney, University of Washington
at Seattle
West Virginia--David G. Williams and L. Christopher Plein West Virginia
University
Wisconsin--Thomas J. Corbett and Thomas J. Kaplan, University of
Wisconsin, Poverty Institute
Chairman Johnson of Connecticut. Mr. Rector.
STATEMENT OF ROBERT RECTOR, SENIOR POLICY ANALYST, HERITAGE
FOUNDATION
Mr. Rector. Thank you very much. I appreciate the
opportunity to be here and testify about out-of-wedlock
childbearing today.
In 1950, about 4 percent of all children were born out of
wedlock; today, that number has risen to 32 percent. As we
speak, one child in the United States will be born out of
wedlock every 35 seconds. During the course of this hearing
there will probably be about 300 children born out of wedlock.
The initial Medicaid costs for the births alone of those 300
children will be about a million dollars.
This is clearly the most important social problem facing
our society today. The first point I would like to make is to
emphasize the very crucial difference between teen pregnancy
and out-of-wedlock childbearing. Only about 14 percent of the
children born out of wedlock in the United States today are
born to girls under age 18. In fact, there are more children
born out of wedlock to women over age 30, than there are to
teenagers in high school. If you look in my testimony, I give a
table on this where I show that the predominant amount of out-
of-wedlock childbearing occurs to young women in their 19, 20,
up to about age 24.
Women having children out of wedlock are mainly young adult
women. In 40 percent of the cases, they are actually cohabiting
with the adult male, the father of that child. Out-of-wedlock
childbearing, the one-million-plus children born out of wedlock
each year is not a matter of high school students. It is, in
fact, a crisis in the enduring relationships between young
adult men and women in the United States, and it is very
important that we recognize that distinction.
Now, I wanted to talk briefly about some of the social
effects of out-of-wedlock childbearing. This is data from the
National Longitudinal Survey of Youth. What we did was look at
children's status at birth and look at the subsequent family
structure for that child.
On the left, we have children that were born out of wedlock
and the mother never marries; and on the extreme right, we have
children that are born inside marriage and the marriage remains
intact. The charts shows the poverty rates during the life of
the child. We find the child born outside of wedlock, where
there never is a marriage, was poor half of the child's life.
By contrast, the child born inside an intact marriage, where
the marriage remains stable, is poor 7 percent of the time. So
there is a 700 percent increase in child poverty that is the
direct result of out-of-wedlock childbearing.
If we could go to the next chart, we see the same sets of
statistics. This chart refers to welfare dependence. The black
column is AFDC receipt. We find a child born outside of the
wedlock, where the mother never marries, received AFDC about 50
percent of the time during this period of analysis.
By contrast, you go over to the right side of the chart, a
child born inside marriage where the marriage remains intact
received AFDC about 3 percent of the time. Again, you have got
something like--in that case, it is more than 1,000 percent
increase, about a 2,000 percent increase in the rate of welfare
dependence as a result of out-of-wedlock childbearing.
Out-of-wedlock childbearing is the primary cause both of
child poverty and of welfare dependence in the United States
today.
A further chart on crime was provided in written testimony,
but I don't have a mock-up of it. We looked at incarceration in
juvenile facilities in the State of Wisconsin where we had
very, very good data. We found that roughly half of the
children--these would be teenagers--incarcerated in juvenile
facilities in Wisconsin were children born out of wedlock where
the mother had never married. Overall, the increase in
probability that a child would commit crimes and end up in
jail, we found it 22 times higher among--for a child that was
born out of wedlock where the mother never marries, compared to
a child born inside wedlock where the biological mother and
father have remained together in a stable marriage.
Out-of-wedlock childbearing and family instability is the
principal cause of crime in the United States today.
Now, we could go on and begin to think about different
policies that we could establish to address this issue. I am
going to emphasize two in my oral testimony. The first is
abstinence education. I would encourage the committee very
strongly to look at a program such as Best Friends in the
District of Columbia, which appears to reduce the sexual
activity rates of inner city girls by about 80 percent. But
beyond that, we need to go on and recognize that the goal here
is not just to get girls out of high school without getting
pregnant. We want to go on and give them the vision and the
skill necessary to form stable marital relationships when they
are young adults in their 20s and are going to begin having
children.
So I would strongly urge expansion of abstinence education,
combined with marriage education to emphasize the importance of
marriage in the lives of men, women and children.
The second policy that I think we should look at very
strongly is to recognize that when a woman has a child out of
wedlock, society pays for that very heavily. For example, for
about 75 percent of the children born out of wedlock, Medicaid
pays for the birth directly. We ought to look at policies,
experiments to reward women not for making mistakes in their
lives, but for doing the right thing. For example, we could
take a group of at-risk women and say, if you get through high
school and if your first birth is within marriage, we will
reward you for taking those steps in the proper direction.
I can't guarantee that that would work, but I would love to
see how individuals would respond to that.
In conclusion, I would say that out-of-wedlock childbearing
is clearly harmful to the child, to the mother, to the father
and to society. The most important and pressing thing we can do
is to communicate the value of marriage, and define policies
that can successfully begin to rebuild marriage in our society.
Chairman Johnson of Connecticut. Thank you very much, Mr.
Rector.
[The prepared statement follows:]
Statement of Robert Rector, Senior Policy Analyst, Heritage Foundation
Out-of-Wedlock Childbearing: Trends and Social Effects
Introduction
I wish to thank the Sub-Committee on Human Resources for
the opportunity to testify today. The views which I will
express are my own and do not necessarily reflect the views of
The Heritage Foundation.
For more than three decades in U.S. society, marriage has
declined, illegitimacy has flourished, and fathers have
disappeared from the lives of children. The upward surge in
out-of-wedlock child bearing has been accompanied by a
mushrooming of other social problems: crime, welfare
dependence, child abuse and drug abuse. The collapse of
marriage, rise of illegitimacy, and absence of fathers are the
root cause behind most of the nation's social problems.
When the American War on Poverty began in 1965, 7 percent
of America's children were born out-of-wedlock, today nearly a
third are. (See Chart 1.) As we speak, one American child is
born outside marriage every 25 seconds.
The rise in illegitimacy has been driven by three factors:
(1) a decline in the portion of women of child bearing age who
are married; (2) an increase in the birth rate of non-married
women; and (3) a decrease in the birth rate of married women.
(See Charts 2 and 3.)
As a result of these factors, the number of births to
married women has declined dramatically and is now at the
lowest level since the end of World War II. During the same
period, out-of-wedlock births have increased 1,000 percent,
rising from 125,000 in 1946 to 1.26 million in 1997.\1\ (See
chart 4.)
The decline in marital births has been particularly severe
among black Americans. Today the number of black children born
within marriage is roughly half the number at the end of World
War II. This change is largely due to a precipitate drop in the
number of adult black women who marry.
Recent Good News
In nearly every year since the mid-1960s, the percentage of
births that were out-of-wedlock increased steadily. In the last
few years, however, there has been modest good news. In 1995,
1996, and 1997, there was a ``pause'' in the growth of
illegitimacy, for the first time in three decades. (See Chart
1) The growth of the white out-of-wedlock birth rate slowed
considerably, and the black rate actually declined slightly.
This ``pause'' in the growth of illegitimacy (which coincided
with the debate and passage of national welfare reform in the
United States) is of great social significance. The crucial
question is whether this pause will continue. Will the share of
births which are outside marriage remain steady, or begin to
fall? Or will illegitimacy soon resume its steady upward climb?
Out-of-Wedlock Childbearing by Ethnic Group
Childbearing out-of-wedlock varies greatly between racial/
ethnic groups. Chart 5 shows the percent of U.S. births that
were out-of-wedlock in 1997 for five separate ethnic groups.
The highest rate was non-Hispanic blacks, among whom 69.4% of
births were out-of-wedlock. American Indians have the second
highest rate at 58.7%, followed by Hispanics at 40.92%. Among
non-Hispanic whites, 21.54 percent of births are out of
wedlock, and Asians/Pacific islanders have the lowest rate with
15.64% of births being out-of-wedlock.
While black Americans have the highest percentage of births
that are out-of-wedlock--this does not mean that most children
born out-of-wedlock in the U.S. are black. In fact, only about
one third of all out-of-wedlock births are to non-Hispanic
blacks.
Moreover, nearly all of the increase in illegitimacy
occurring in recent years is due to whites. Between 1980 and
1997, annual black non-marital births increased by only about
100,000. By contrast, white out-of wedlock births more than
doubled (rising from 328,984 to 793,202). In 1980 the numbers
of black and white out-of-wedlock births were nearly equal; by
1997 there were almost two white out-of-wedlock births for each
black birth.
Out-of-Wedlock Childbearing and Teen Pregnancy
The rise of illegitimacy in the U.S. should not be confused
with teenage pregnancy. Out-of-wedlock child bearing is
overwhelmingly a problem among young adult women (age 18 to
25), not minor teenage girls in high school. Only 13.17 percent
of out-of-wedlock births occur to girls under 18. In fact, more
out-of-wedlock births occur to women age thirty and over, than
to minor teenage girls. (See Chart 6.) Out-of-wedlock
childbearing is not primarily the product of careless and
haphazard behavior between sexually active high school
students, instead it represents a profound crisis in the
relationships between young adult men and women.
Other Social Factors Relating to Out-of-Wedlock Childbearing
The conventional image is that out-of-wedlock births are
largely the result of accidental pregnancy. In fact, nearly
half of all illegitimate births are the result of an intended
pregnancy; 34 percent are the result of a pregnancy that
occurred earlier than the mother wished and only 14 percent are
the result of a pregnancy that was completely unwanted. (See
Chart 7)
There is a strong tendency toward repeat out-of-wedlock
births. Roughly half of all illegitimate births are not first
births, but are second, third or even later births to the
mother. (See Chart 8.)
Most out-of-wedlock births do not occur as a result of
ephemeral sexual encounters between near strangers. In fact,
nearly forty percent of all out-of-wedlock births occur to
women who are cohabiting with an adult male, who in most cases
is the newborn's father. (See Chart 9.) Regrettably, these
cohabiting relationships are unstable and generally dissolve
within a few years rather than evolving into marriage.
A key factor in determining whether a woman will have a
child out-of-wedlock is religious belief and practice. Regular
church attendance cuts the probability of having a child out-
of-wedlock roughly in half. (See Chart 10.)
Social Effects of the Rise in Non-Marital Births
The decline in marriage and the rise in out-of-wedlock
childbearing has been associated with host of other social
problems. In particular, the rise in illegitimacy has been a
primary factor contributing to increases in: child poverty;
welfare dependence; behavioral and emotional problems; and
crime. In addition, the decline in marriage has been associated
with high numbers of abortions.
Social Effect #1: Out-of-Wedlock Childbearing and Poverty
The most obvious consequence of the rising tide of
illegitimacy and disappearance of fathers is child poverty.
Chart 11 shows data from the National Longitudinal Survey of
Youth (NLSY) which contains a nationally representative sample
of young mothers and their children. The chart divides children
into four groups:
1. Out-of-Wedlock-Never Married--Children born out of
wedlock whose mother has never married after the birth of the
child;
2. Out-of-Wedlock-Subsequent Marriage--Children born out of
wedlock whose mother marries subsequent to the child's birth;
3. Within Wedlock-Divorced--Children born to married
parents who later divorce;
4. Within Wedlock-Marriage Intact--Children born to parents
who were married at the time of birth and remained married
The chart shows the amount of time since birth that a child
has lived in poverty for the four different categories of
children. Children born out-of-wedlock to never married women
are poor fifty-one percent of the time. By contrast children
born within a marriage which remains intact are poor 7 percent
of the time. Thus the absence of marriage increases the
frequency of child poverty 700 percent. However, marriage after
an illegitimate birth cuts the child poverty rate in half.
Social Effect #2: Out-of-Wedlock Childbearing and Dependence
A second consequence of father absence and out-of-wedlock
births is prolonged welfare dependence. Chart 12, using data
from the NLSY, separates children into the same four groups as
the previous chart on poverty. Children born out-of-wedlock
whose mothers have not married have received Aid to Families
with Dependent Children (AFDC) benefits for fifty percent of
the time since birth. By contrast, children who were born in
wedlock and whose parents have remained married have received
AFDC only 3 percent of the time since birth. Thus AFDC receipt
is 1700 percent more frequent among illegitimate children of
never married mothers than among legitimate children raised by
intact married couples.
If a woman gives birth out-of-wedlock but subsequently
marries, the average length of time spent on AFDC will be cut
in half, falling from 50 percent (for children of never married
mothers) to 23 percent. Marriage even after an out-of-wedlock
birth is thus quite effective in reducing dependence.
Conversely if the parents of a legitimate child divorce, the
length of time on AFDC will rise from 3 percent (for intact
married couples) to 13 percent for divorced families.
Chart 12 also shows the portion of time which children in
the four different categories received any of the following
means-tested welfare benefits: AFDC, Food Stamps, Medicaid,
SSI, and WIC. On average, children in the ``out-of-wedlock-
never married'' group received some form of welfare benefit for
71 percent of the months since birth. By contrast, legitimate
children whose parents remained married have received some
welfare for 12 percent of the time. Welfare receipt is six
times greater among the never-married group.
Social Effect #3: Out-of-Wedlock Childbearing and Emotional and
Behavioral Problems
Data from the National Health Interview Survey of Child
Health (NHIS-CH) confirm that children born out of wedlock have
far more behavioral and emotional problems than do children in
intact married families. These problems include:
Antisocial behavior--disobedience in school, cheating and
lying; bullying and cruelty to others; breaking things
deliberately; failure to feel sorry after misbehaving;
Hyperactive behavior--difficulty concentrating or paying
attention; becoming easily confused; acting without thinking;
being restless or overactive;
Headstrong behavior--easily losing one's temper; being
stubborn, irritable, disobedient at home; arguing excessively;
Peer conflict--having trouble getting along with others,
being not liked, being withdrawn;
Dependent behavior--crying too much, being too dependent on
others, demanding attention, clinging to adults.
Children raised by never-married mothers have significantly
higher levels of all of the above behavior problems when
compared to children raised by both biological parents. When
comparisons are made between families that are identical in
race, income, number of children, and mother's education, the
behavioral differences between illegitimate and legitimate
children actually widen. Compared to children living with both
biological parents in similar socioeconomic circumstances,
children of never-married mothers exhibit 68 percent more
antisocial behavior, 24 percent more headstrong behavior, 33
percent more hyperactive behavior, 78 percent more peer
conflict, and 53 percent more dependency. (See Chart 13.)
Overall, children of never-married mothers have behavioral
problems that score nearly three times higher than children
raised in comparable intact families.\1\
---------------------------------------------------------------------------
\1\ Deborah A. Dawson, ``Family Structure and Children's Health and
Well-being: Data from the 1988 National Health Interview Survey on
Child Health,'' paper presented at the annual meeting of the Population
Association of America, Toronto, May 1990.
---------------------------------------------------------------------------
In addition, children born out of wedlock have less ability
to delay gratification and poorer impulse control (control over
anger and sexual gratification). They have a weaker sense of
conscience or sense of right and wrong.\2\ Adding to all this
is the sad fact that the incidence of child abuse and neglect
is higher among single-parent families.\3\
---------------------------------------------------------------------------
\2\ E.M. Hetherington and B. Martin, ``Family Interaction,'' in
H.C. Quay and J.S. Werry (eds.), Psychopathological Disorders of
Childhood (New York: John Wiley & Sons, 1979), pp. 247-302.
\3\ A. Walsh, ``Illegitimacy, Child-Abuse and Neglect, and
Cognitive Development,'' Journal of Genetic Psychology, Vol. 15 (1990),
pp. 279-285.
---------------------------------------------------------------------------
Being born out-of-wedlock and growing up in a single-parent
family means the child is more likely to experience: retarded
cognitive (especially verbal) development; lower educational
achievement; lower job attainment; increased behavior and
emotional problems; lower impulse control; and retarded social
development. Such children are far more likely to: engage in
early sexual activity; have children out of wedlock; be on
welfare as adults; and engage in criminal activity.\4\
---------------------------------------------------------------------------
\4\ See Robert Rector and Patrick F. Fagan, ``How Welfare Harms
Kids,'' The Heritage Foundation Backgrounder, No. 1084, June 5, 1996.
---------------------------------------------------------------------------
Social Effect #4: Out-of-Wedlock Childbearing and Crime
Research by former Congressional Budget Office Director Dr.
June O'Neill demonstrates the clear linkage between crime and
single-parent families. Using data from the National
Longitudinal Survey of Youth, O'Neill found that young black
men raised in single-parent families were twice as likely to
engage in criminal activities when compared to black men raised
in two-parent families, even after holding constant a wide
range of variables such as family income, urban residence,
neighborhood environment, and parents' education. Growing up in
a single-parent family in a neighborhood with many other
single-parent families on welfare triples the probability that
a young black man will engage in criminal activity.\5\
---------------------------------------------------------------------------
\5\ M. Anne Hill and June O'Neill, Underclass Behaviors in the
United States: Measurement and Analysis of Determinants, New York City,
City University of New York, Baruch College March 1990.
---------------------------------------------------------------------------
Even stronger evidence is provided by a study of the family
backgrounds of youths incarcerated in juvenile correctional
jails in Wisconsin in 1993.\6\ As Chart 14 shows, only 13
percent of the juvenile offenders came from married couples
where the child's biological father and mother were currently
married and living together. In other words 87 percent of the
juvenile criminals in Wisconsin came from never married or
broken homes.
---------------------------------------------------------------------------
\6\ Wisconsin Department of Health and Social Services, Division of
Youth Services, Family Status of Delinquents in Juvenile Correctional
Facilities in Wisconsin, April 1994.
---------------------------------------------------------------------------
The report clearly demonstrates, not only that most
juvenile crime is performed by youth from splintered homes, but
that such children are far more likely to commit crimes than
are those from homes with intact marriages. While only 13
percent of incarcerated offenders were from married couple
homes with two biological parents, United States Census data
shows that roughly half of Wisconsin teenagers actually lived
in such intact married families in 1990.\7\
---------------------------------------------------------------------------
\7\ General figures on Wisconsin teenagers are from a Heritage
Foundation calculation based on the public use sample of the 1990
Census. The overall statewide percentage of Wisconsin teenage children
residing with two married biological parents was adjusted downward to
compensate for the underreporting of step child status in the Census
data.
---------------------------------------------------------------------------
Chart 15 shows the comparative probability of juvenile
incarceration based on family structure. A child living with a
never-married family was more than 22 times likely to be
incarcerated for criminal activities than is a youth raised by
married biological parents. Children from divorced, separated,
and widowed families were some three times to be incarcerated
for criminal activity than was a child from an intact married
family with both biological parents.\8\
---------------------------------------------------------------------------
\8\ Based on data provided by Pat Fagan. Due to limitations in the
Census data on Wisconsin youth in general these figures should be
interpreted as rough probabilities rather than precise estimates.
---------------------------------------------------------------------------
Social Effect #5: The Decline in Marriage and Abortion
Abortion in America is profoundly linked to the sharp
decline in marriage and the increase in non-marital sexual
activity outside of marriage. About 5.5 million pregnancies
occur in the U.S. each year; nearly half (44 percent) of these
pregnancies are to non-married women.\9\ Surprisingly, the
pregnancy rate among never married women is virtually the same
as for married women. In 1994 there were 95 pregnancies per
thousand married women age 15 to 44. Among never-married women
the rate was 91 pregnancies per thousand.
---------------------------------------------------------------------------
\9\ Stanley K. Henshaw, ``Unintended Pregnancy in the United
States'' Family Planning Perspectives, January/February 1998.
---------------------------------------------------------------------------
However, while married and non-married women have similar
pregnancy rates, they differ greatly in whether a pregnancy is
carried forward to childbirth. Nearly half of all pregnancies
among non-married women end in abortions. By contrast, only 11
percent of pregnancies among married women end in abortion.\10\
(See Chart 16.) Overall, three quarters of abortions in the
U.S. are performed on non-married women.\11\
---------------------------------------------------------------------------
\10\ Ibid.
\11\ Ibid. p. 26
---------------------------------------------------------------------------
Some believe there may be a trade off between abortion and
out-of-wedlock childbearing, maintaining that abortion may be
decreased by increasing illegitimate births or vice versa. The
facts do not support this view. In reality, those states with
high abortion rates also have a higher rates of out-of-wedlock
childbearing.\12\ This is because both illegitimacy and
abortion stem from a common source: the decline in marriage.
Therefore policies which would strengthen marriage in our
society would have a double effect of reducing both out-of
wedlock childbearing and abortion.
---------------------------------------------------------------------------
\12\ Using state level data the correlation between the number of
illegitimate births per 1,000 women aged 15-44 and number of abortions
per 1,000 women aged 15-44 ranges from +.67 to +.72. See Robert Rector,
``The Fallacy that Welfare Reform Will Increase Abortions,'' The
Heritage Foundation Executive Memorandum, No.407, March 21, 1995.
---------------------------------------------------------------------------
Out-of-Wedlock Births, Marriage, and Welfare
The decline of fatherhood and marriage has been tied to the
growth of the welfare state and is inherent in the structure
government welfare programs. Welfare programs are programs
which are ``means-tested'' or ``income-limited:'' this means
that benefits from a welfare program are restricted to
households whose non-welfare income falls below a certain
limit. This restriction may take the form of an abrupt
termination of eligibility when non-welfare income reaches a
specified level, but is more likely to take the form of a
graduated schedule in which benefits are incrementally reduced
as non-welfare income rises.
In the United States, there are over 70 major income-tested
welfare programs. These provide cash, food, housing, medical
care and targeted social services to low income persons.
Federal and state spending on these programs costs over $400
billion per year or 5 percent of the U.S. Gross Domestic
Product. About half of this welfare spending is directed to
families with children.
It is critical to understand that all means-tested welfare
programs are inherently anti-marriage and produce what has been
termed ``household splitting effects.'' This occurs because
welfare benefits fall as household earnings rise; welfare can
thus be maximized by removing an employed father from the home
or taking steps to ensure his earnings are formally disregarded
by the welfare system.
To understand how this process works in the U.S., we can
imagine an example: ``Annie,'' a mother, and ``Bill,'' the
employed father of her children. If Annie and Bill are not
married and merely cohabit, Bill's earnings will generally be
disregarded by the government and Annie will receive a variety
of welfare benefits. If, on the other hand, Annie and Bill get
married, Bill's earnings will immediately count against Annie's
welfare eligibility and her benefits will be terminated or
substantially reduced.\13\
---------------------------------------------------------------------------
\13\ A rule against cohabitation by welfare mothers could be used,
but it would be difficult to enforce and might only push ``Bill'' from
the home.
---------------------------------------------------------------------------
There are various permutations on this principle, but the
underlying rule is always the same: if a mother and father
present themselves as two separate legal units to the
government, they will usually be able to draw on two sources of
income, welfare and the father's earnings. If, however, the
mother and father are a married couple, they will receive, in
general, only one source of income, the father's earnings.
It is crucial to understand that this is not a small
accident in the welfare system, but is the inevitable result of
the nature of ``means-tested'' welfare. Such welfare programs
are inherently biased not against marriage, per se, but against
the earnings of an employed husband.\14\ Earnings jeopardize
welfare income; welfare benefits will be maximized only if the
husband does not work, or if the father and mother are not
married.
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\14\ Traditional welfare programs also create a strong incentive
for the mother not to work or to hide her earnings from the government.
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The very structure of welfare programs thus implicitly
penalizes married couples with an employed husband with a low
or moderate income. The only way to eliminate this bias would
be to universalize all means-tested benefits currently targeted
toward single mothers. Under a universalized system, all
mothers would receive the same benefits irrespective of marital
status and irrespective of their husband's earnings level.
Under such a hypothetical system, no mother would suffer a
reduction in welfare because she was married to a working
husband.
Such a universal benefit system would be extraordinarily
expensive. Moreover, even in such a system, anti-marriage
effects would remain. The presence of generous universal
supports to all mothers would undermine the economic necessity
of marriage, rendering husbands' earnings less necessary or
even superfluous. This would be particularly true for low wage,
low skill fathers, precisely the group for whom marriage has
become the most tenuous.
Provisions Relating to Marriage and Illegitimacy in the 1996
Welfare Reform
The Personal Responsibility and Work Opportunity
Reconciliation Act enacted in 1996 contained several key
provisions designed to strengthen marriage and reduce
illegitimacy.
(1) The law established for the first time in the nation's
history, a clear goal to ``prevent and reduce the incidence of
out-of wedlock pregnancies.''
(2) It required states to establish annual numerical goals
for reducing out-of-wedlock childbearing.
(3) It created an illegitimacy ratio reduction bonus fund
of $50 million per year to reward states which decrease the
percentage of births which occur outside of marriage without
increasing abortions. Up to five states may receive funds each
year under this provision.
(4) It created a new program to provide abstinence
education directed toward marriage with funding of $50 million
per year.
Finally, during the national debate on welfare reform
running from 1994 through 1996, Congress for the first time in
the nation's history engaged in a clear and forthright debate
concerning the societal harm caused by illegitimacy and the
linkage between welfare and out-of-wedlock childbearing. This
debate broke a spell of silence which had prevailed on this
issue for more than three decades.
For the first time, the majority of the members of both
parties were clear in affirming both the harm of illegitimacy,
and the desirability of strengthening marriage. During this
period, press coverage on the harmful effects of illegitimacy
on children and society increased tenfold. The clear public
discourse on the value of marriage and ills associated with
out-of wedlock childbearing--reinforced by the underlying theme
of personal responsibility embodied in reform legislation--
played a critical role in the unexpected halt in the growth of
illegitimacy which began in 1995.
New Policy Directions
Since most other social problems stem from or are closely
associated with the dramatic decline in marriage, the
restoration of marriage must be our top social priority. Given
the anti-marriage bias inherent in means-tested programs, it
will be very difficult to eliminate the all anti-marriage
effects from our welfare system. But this does not mean that
positive steps to strengthen and promote marriage cannot be
taken. Such positive steps would include:
1. Constantly Articulate the Goal of Marriage.--The death
of marriage is the central social problem facing our society.
The first step in restoring marriage would be for social and
political leaders to forcefully provide the message that
marriage is essential to the welfare of men, women and
children, and that bearing and raising children out-of wedlock
is undesirable for both the child and society.
2. Provide Abstinence and Marriage Education.--Young people
should be educated about the crucial linkage between marriage,
human happiness, and social well-being. (This message is
completely absent in our schools.) They should be instructed in
the value of abstaining from sexual activity until marriage,
and should be taught the inter-personal skills needed to build
strong and committed relationships between men and women.
3. Increase the Illegitimacy Reduction Bonus Fund.--As
noted, the 1996 welfare reform law created a pool of money to
reward states which decrease out-of-wedlock childbearing
without increasing abortion. Funding for this program should be
increased and awards should be made available to more than five
states.
4. Establish Mentoring and Counseling Programs to Expand
and Strengthen Marriage.--Marriage development and protection
programs should be established in communities with a high level
of out-of wedlock child bearing and low levels of marriage. The
inclusion of community and religious groups in such efforts
would be critical. Such programs should include: mentoring
programs to help restore role models of successful marriage in
communities where marriage has greatly eroded; counseling
programs to instill the goal of successful marriage and to
develop relationship skills among at-risk men and women; and
support programs to strengthen fragile new marriages.
5. Limit Subsidization of Single Parenthood.--Welfare
subsidies serve as a competition to marriage and undermine the
importance of moderate-skilled men as breadwinners and
husbands. Limitations should be placed on traditional welfare
subsidies to single parents; these would include policies such
as work requirements and providing loans rather than grants.
6. Reward Marriage Among At-Risk Groups.--New programs
should be devised which communicate social and governmental
affirmation of marriage, and which explicitly reward the
initiation and continuance of marriage by at-risk individuals.
Conclusion
The 1996 welfare reform act stated correctly that
``marriage is the foundation of a successful society.'' The
decline in marriage and the growth in out-of-wedlock
childbearing is injurious to the well-being of children,
mothers, fathers and society at large. No task is more
important or pressing than the restoration and strengthening of
marriage in our society.
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Chairman Johnson of Connecticut. Ms. Sawhill, it is a
pleasure to welcome you back.
STATEMENT OF ISABEL V. SAWHILL, PH.D., SENIOR FELLOW, BROOKINGS
INSTITUTION, AND PRESIDENT, NATIONAL CAMPAIGN TO PREVENT TEEN
PREGNANCY
Ms. Sawhill. Thank you very much, Madam Chair. I am really
delighted to be here.
The first question I want to raise is, why should we care
about nonmarital childbearing. Here I simply want to stress
that all of our research suggests that children are better off
in two-parent than in one-parent families. They do better in
school; they have fewer behavioral and social problems. Even
after you adjust for economic differences between two-parent
and one-parent families, the children in one-parent families
are worse off.
However, the biggest problem is that children in single-
parent families have much lower incomes than those in two-
parent families, as I show in figure 1.
The poverty rate amongst the children of never-married
mothers is six times as high as the poverty rate in two-parent
families, and this relationship holds no matter what racial or
ethnic group you are looking at.
Given the enormous differences in the economic situation of
these different types of families, it is not too surprising
that given the growth of both nonmarital childbearing and
single-parent families, that we have experienced an upward
trend in child poverty rates since about 1970. The main factor
that is driving the increase in single-parent families in the
last decade or so has been nonmarital childbearing. It used to
be divorce that was driving the growth of single-parent
families; it isn't anymore. The divorce rate has leveled off.
So, it is now nonmarital childbearing that is driving up the
number of single-parent families, and it is the growth in
single-parent families, in turn, that is responsible for much
of the increase in child poverty, as you can see in figure 2
where we have adjusted the poverty rates for changes in family
structure. We asked what would the poverty rate amongst
children be in 1996 if we still had the same family structures
that we did back in 1970; and the answer is, there wouldn't be
much more child poverty now than there was in that earlier
year.
Now, all of this is by way of saying that marriage is a
powerful antipoverty strategy, but many people say, ``Well, the
reason that marriage has collapsed is because men don't have
the earnings and the employment that they used to, particularly
less-skilled, less-educated men, and therefore, men and women
aren't getting married.'' There is no sense in taking on a
husband if that husband can't earn enough to support a family;
and there is a little evidence that declining earnings among
men has played some role, but I don't think it has played the
dominant role.
And to further reinforce the point that marriage is a good
antipoverty device, in figure 3, I compare two families. One is
a single-parent family with two children, working in a minimum
wage job full-time, and the second is a married couple in which
both parents are also working full-time at minimum-wage jobs.
In both cases, they get the Earned Income Tax Credit, although
a little less EITC in the second case than in the first. But as
you can see very clearly, this second family is economically
much better off, even though neither of the parents is earning
very much.
We haven't taken into account child care costs here, which
changes the picture somewhat, and we can go into that later if
you like.
I think both Robert Rector and Stephanie Ventura made the
point that not all out-of-wedlock or nonmarital births are to
teenagers, and that is true, but I want to emphasize that half
of first nonmarital births are to teenagers and that those
births are overwhelmingly unplanned and unintended. In fact,
about one-fifth of all teenage girls in the United States can
be predicted to have a child out of wedlock given current
rates.
So I think that when it gets to the question of what can be
done, a very good place to focus our efforts is on reducing
teenage pregnancies for several reasons. First, that is where
the pattern of out-of-wedlock childbearing starts; second, that
is the group for whom the consequences are most devastating,
and third, that is the group for which the greatest social
consensus exists that something needs to be done. You are going
to hear more from Brenda Miller, my colleague at the National
Campaign to Prevent Teen Pregnancy, about the strategy that we
have adopted at the National Campaign for reducing teenage
pregnancy. But one of the reasons that I got involved in
helping to found the National Campaign to Prevent Teen
Pregnancy is because I felt that reducing teenage pregnancies
was one of the most highly leveraged and important things we
could do to reduce poverty, welfare dependency and a whole host
of social problems that several people have already alluded to.
The good news is that teen pregnancy and birthrates have
been declining since the early 1990s, but bear in mind that we
still have rates that are much higher than in any other
industrialized country. I am talking about five or six times as
high as in Europe.
On this question of abstinence versus contraception, it is
very divisive. There is a huge debate out there, as Dr. Nathan
has suggested. This is one reason why it has been so difficult
to move forward at the local level. We have done polling data
on this, and our polling data suggests that there is a strong,
indeed, I would say, an overwhelming, consensus in the country
that we should promote abstinence amongst school-age youth, but
the public does not want contraceptives to be taken away. They
want to have them available as a backup.
So, as I think you said, Madam Chair, we need a more
balanced conversation about this. We need abstinence to be our
first message, but we need to have contraceptives available for
those who need them.
I could go on and make a number of other recommendations,
but in the interest of time and seeing the red light, I will
leave it at that for now. Thank you.
[The prepared statement follows:]
Statement of Isabel V. Sawhill, Ph.D., Senior Fellow, Brookings
Institution, and President, National Campaign to Prevent Teen Pregnancy
I appreciate the opportunity to testify on this important
topic. Both as President of the National Campaign to Prevent
Teen Pregnancy and as a Senior Fellow at the Brookings
Institution, I have become convinced that early out-of-wedlock
childbearing is bad for parents, bad for society, and
especially bad for the children born into such families.
However, the views I express today are my own and should not be
attributed to a particular institution with which I am
associated.
Three years after the enactment of welfare reform, the new
law is being hailed as a great success. Caseloads have declined
dramatically since the law was signed, and with fewer
individuals to support, the states are flush with money. A
strong economy interacting with tougher welfare rules and more
support for the working poor is helping to turn welfare checks
into paychecks. But the welfare system is like a revolving
door. In good times, more people move off the rolls than come
on and caseloads decline. But in bad times, exactly the reverse
can occur. The only way to permanently reduce poverty and its
associated expense is to stem the longer-term trends in out-of-
wedlock childbearing that have historically pushed child
poverty and caseloads up. Unless the states invest their
surplus funds in programs aimed at preventing poverty, success
may be short-lived or purchased at the expense of the children
it was designed to help. If every recipient who finds a job is
replaced by a younger sister ill-prepared to support a family,
the immutability of the revolving door will once again prevail.
There are many ways of preventing poverty. We could invest
in early childhood education, inner city schools, or in
additional supports for the working poor. But unless we can
reduce out-of-wedlock pregnancies and encourage the formation
of two-parent families, other efforts, by themselves, may well
fail.
Much more attention needs to be given to encouraging young
people to defer childbearing until they are ready to be
parents. Some of the funds freed up by the drop in caseloads
ought to be invested in teen pregnancy prevention programs and
in reconnecting fathers with their children. In the absence of
such efforts, welfare reform's current success is likely to be
short-lived.
Family Structure and Welfare Dependency
Rising divorce rates combined with a huge increase in
childbearing outside of marriage have led to a situation in
which most children born today will spend some time in a single
parent family. And since roughly half of these single parents
are poor (Figure 1), large numbers of children are growing up
in poverty as well. Indeed, the growth of single parent
families can account for virtually all of the increase in child
poverty since 1970 (Figure 2).
The growth of female-headed families has also contributed
to the growth of the welfare rolls. According to the
Congressional Budget Office, welfare caseloads would have
declined considerably throughout most of the 1980s if it had
not been for the fact that the growth of single parent families
continued to push them upwards. Moreover, this factor was more
than twice as important as the economy in accounting for the
roughly one million increase in the basic caseload between 1989
and 1993.
It is not just the growth of female-headed families but
also shifts in the composition of the group that have
contributed to greater poverty and welfare dependency. In the
1960s and 1970s, most of the growth of single parent families
was caused by increases in divorce or separation. In the 1980s
and 1990s, all of the increase has been driven by out-of-
wedlock childbearing. Currently, 32 percent of all children in
the United States and more than half in many large cities are
born outside of marriage. Unmarried mothers tend to be younger
and more disadvantaged than their divorced counterparts. They
are overwhelmingly poor (Figure 1) and about three-quarters of
them end up on welfare.
A large fraction of babies born outside of marriage have
mothers who are not teenagers. However, the pattern of out-of-
wedlock childbearing is often established at a young age.
Specifically, more than half of first out-of-wedlock births are
to teens. So if we want to reduce such births and the welfare
dependency that usually ensues, the adolescent years are a good
place to start.
There are two strategies that can be used to reduce teen,
out-of-wedlock births. One is to encourage marriage. The other
is to discourage sex, pregnancy, and births among teens. This
latter strategy has the advantage of being more consistent with
the growing requirements of the economy for workers with higher
levels of education and with evidence that teenage marriages
are highly unstable.
Out-of-Wedlock Childbearing: Cause or Symptom of Poverty?
Some contend that many of the women who have babies as
unmarried teens would have ended up poor and on welfare even if
they had married and delayed childbearing. The argument is that
they come from disadvantaged families and neighborhoods, have
gone to poor schools, or faced other adverse influences that
make having a baby at a young age as good an option as any
other. There are few men with jobs for them to marry, and given
their own lack of skills, welfare seems like a relatively good
alternative. Moreover, earnings for less skilled men have
plummeted over the past 30 years.
Although such arguments cannot be dismissed entirely, they
are only a small part of the story. To begin with, the drop in
marriage rates, which has been especially pronounced among
African Americans, has been much larger than any economic model
can explain. Second, early childbearers are much less likely to
complete high school, leading directly to poor long-term
employment prospects for the young women involved. The children
in such families suffer even greater adverse consequences,
including poorer health, less success in school, and more
behavior problems. Finally, the argument that declining
earnings has made marriage less viable is a curious one. Two
adults can live more cheaply than one, and by pooling whatever
earnings can be secured from even intermittent or low paid
employment, they will be better off than a single adult living
alone. These arguments are doubly true once a child enters the
picture and one parent either needs to stay home or shoulder
the extra expense of paying for child care.
One can grant that the earnings prospects of poorly
educated, inner city residents are not good and have
deteriorated in recent decades, and that better schools and
more support systems for low-income working families would
help. Still, early out-of-wedlock childbearing greatly
compounds the problem. Even well-educated individuals in their
twenties have difficulty living on one income these days, and
most middle class families have two earners. Yet, for some
reason, it is assumed that if the men in low-income communities
can't command a decent wage, they are not marriageable. But
fathers are, or should be, more than just a meal ticket. And
although two minimum wage jobs will not make anyone rich, they
will provide an income of about $20,000 a year, well above the
poverty level for a family with two children (Figure 3). In
short, marriage and delayed childbearing have the potential to
solve a lot of problems, including assuring a better future for
the next generation.
Why Are Teen Pregnancy and Out-of-Wedlock Birth Rates So High?
As teen pregnancy and childbearing have become more common,
they have also become more acceptable, or at least less
stigmatized. A few decades ago, there were real social
penalties to be paid if a girl became pregnant outside of
marriage. Young girls refrained from sex for fear of becoming
pregnant and being socially ostracized. Among those who did get
pregnant, shotgun marriages were common. Young men had to
compete for women's affections by promising marriage or at
least commitment. All of this changed during the 1970s and
1980s. Contraception and abortion became much more available,
women became more liberated, and sexual mores changed
dramatically. A study by George Akerlof and Janet Yellen
documents how the decline in shotgun marriages contributed to a
rising tide of out-of-wedlock births. But this same change in
sexual mores led not just to fewer marriages but also to a lot
more sexual activity and a rising pregnancy rate among the
nation's youth.
As Figure 4 shows, teen pregnancy rates increased from the
early 1970s until 1990 and have been declining since that time.
The relatively modest growth depicted in the chart is the
result of two offsetting trends since 1972: increased sexual
activity among teens combined with greater use of
contraception. If teens had not increased their use of
contraception over this period, teen pregnancy rates would have
soared and been almost 40 percent higher by now. On the other
hand, contraceptive use did not keep pace with the greater
tendency of teens to engage in sex, with the result that, up
until recently, the pregnancy rate kept rising. In the war
between sex and safer sex, sex won.
These increases in pregnancy rates have not always
translated into higher birth rates. The greater availability of
abortion after 1973 kept the teen birthrate somewhat in check.
But few people, whatever their position on this difficult
issue, want abortion to be the major means of preventing
poverty and welfare dependency.
The Good News: Teen Pregnancy and Birth Rates Are Now Declining
In the 1990s, teenage sexual activity stopped increasing or
even declined a bit. This combined with greater utilization of
contraception among teens has caused the teen pregnancy rate to
decline for the first time in decades. Teen births have fallen
as well and the proportion of all children born out-of-wedlock
has stabilized. The drop in birth rates among unmarried black
teens is especially striking. It has declined by almost one
fifth since 1991, a much sharper drop than that experienced by
any other group.
What has caused this recent turnaround in sexual activity,
pregnancy, and out-of-wedlock births? No one really knows but
there are several possible explanations. One is fear of AIDS,
which is widely suspected to be the most important reason for
teens' willingness to either abstain from sex or use
contraception more frequently than in the past.
Another possible explanation is welfare reform itself.
Although the trends predate welfare reform, they may have
gotten an extra push from the debate leading up to enactment of
the new law in 1996 and the state reforms that preceded it.
Most researchers don't expect welfare reform to have a big
impact on out-of-wedlock childbearing. (Past studies are
somewhat inconsistent, but most find that welfare has had only
minor effects.) However, the new law makes welfare, and thus
unwed motherhood, as a life choice much more difficult. And
past research may not be a very good guide to future behavior
because it has been based on variations in welfare benefits
across states, not system-wide changes that are accompanied by
time limits and strong moral messages that have the potential
to change community norms.
Another factor that can't be dismissed is the performance
of the economy over this period. The unemployment rate peaked
in 1992 at 7.5 percent and has fallen sharply since. The long
and very robust expansion, combined with increases in the
minimum wage and in the Earned Income Tax Credit, may have
helped to make work more attractive than welfare, and provided
young women with more of a reason to defer childbearing. (This
explanation is consistent with a surprisingly steep rise in the
labor force participation of less educated single mothers since
1990.) And finally, tougher enforcement of child support laws
may have made young men think twice before producing a baby.
Given All This Good News, Why Worry?
Although recent declines auger well for the future, it is
worth remembering that teenage pregnancy rates are still at
least twice as high as in other industrialized countries and
higher than they were in the early 1970s. About half of these
pregnancies are carried to term while the remainder either end
with a miscarriage or are terminated by an abortion. Very few
teen mothers put their babies up for adoption, or marry the
baby's father, a marked departure from practices 30 or 40 years
ago.
All of these considerations suggest that unless welfare
reform begins to modify the underlying demographic trends that
contribute to poverty and welfare dependency, it may do little
more than reshuffle poor mothers and their children between
welfare and low-paid work or worse. With the help of a strong
economy, states could end up being quite successful at moving
existing recipients off the welfare rolls. But unless they also
focus on the number coming in the front door of the welfare
system, this could be a hollow victory. Congress has created an
incentive for states to reduce teen and out-of-wedlock
childbearing by offering a bonus of $20 million annually to the
most successful states, and this has served as a wake-up call
for some governors. But as Richard Nathan at SUNY Albany
reports, many states have been reluctant to address the issue,
considering it too hot to handle. They have tossed this
political hot potato to local governments and nonprofit
organizations.
What Else Can Be Done?
Efforts to reduce teen pregnancy have traditionally
centered on sex education and family planning services. Sex
education, although widely available, is often too little and
too late to have much impact. The best curricula focus less on
reproductive biology than on teaching adolescents the skills
needed to handle relationships, resist peer pressures, and
negotiate difficult situations. Although teens are using
contraception much more frequently than in the past, and their
preferred method--condoms--is widely available in stores, they
do not typically use it consistently, especially when they are
young. The result is that failure rates are high and unplanned
pregnancies all too common. Even a 12 percent annual failure
rate, typical for condom users, cumulates to an almost certain
pregnancy in the dozen years between puberty and marriage or an
adult job. Part of the problem is that the boys and young men
involved are not held accountable for their actions. Although
the new welfare law puts considerable emphasis on establishing
paternity and collecting child support from fathers, up until
now, most have had a free ride. Unwed fathers need to be
offered the same work opportunities and be subjected to the
same requirements as the mothers of their children. And if
Congress wants to do something about the so-called ``marriage
penalty,'' the place to start is with the Earned Income Tax
Credit (EITC). As a result of the credit, a working single
parent with two children can qualify for almost $4,000 a year.
But if she marries another low-wage earner, she stands to lose
most or all of these benefits. Congress should consider basing
the credit on individual rather than family earnings. (A
requirement that couples split their total earnings before the
credit rate was applied would prevent benefits from going to
higher income families.) Under such a revised EITC, incentives
to marry would be greatly enhanced.
In the meantime, efforts to equip adolescents with the
knowledge and the means to avoid pregnancy in the first place
have been highly charged politically and have created a
backlash by conservatives, and even by some moderates, who want
more emphasis placed on abstinence. Public opinion polls show
that over 90 percent of the public believes that abstinence is
the appropriate standard for school-age youth, even though a
majority still wants contraceptives to be available as a
backup. (Contrary to what some believe, there is no evidence
that teaching young people how to protect themselves causes
them to have more sex.) As part of the 1996 welfare reform
bill, Congress provided $50 million a year for abstinence
education programs. Such programs have never been adequately
evaluated and many experts are skeptical that ``just say no''
campaigns by themselves will have much effect. But there is
newfound appreciation for the need to encourage abstinence,
especially among younger teens. In addition, if these or other
funds were used for programs such as mentoring, community
service, or after school activities, it could make a
difference.
Those looking for guaranteed programmatic solutions to this
problem are likely to be disappointed. The point is not that
programs can't be effective, but that in isolation from a
change in social norms, their impact may be small. Conversely,
an intervention that begins by affecting behavior in quite
modest ways may eventually produce changes in norms that
snowball into bigger long-term effects. Behavior is contagious.
Teens, in particular, are enormously influenced by what their
friends, parents, and heros say and do, as documented in
research commissioned by the National Campaign to Prevent Teen
Pregnancy. This suggests that programs not be judged only on
the basis of their immediate effects but also on their
potential to reengage parents and reorient peer culture. It
also suggests devoting some funds to media campaigns and to
support for community or youth-led efforts that focus on values
and not just services.
In conclusion, reducing teen pregnancy could substantially
decrease child poverty, welfare dependency, and other social
ills. Although little is known with certainty about how to
advance this objective, states now have the opportunity to
experiment with a variety of promising approaches that are
critical to the longer-term success of current welfare reform
efforts. Whatever approach states choose, they should remain
cognizant of the importance of strengthening the social norm
that teen out-of-wedlock childbearing is--to put it most
simply--wrong.
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Mr. Cardin. Madam Chair, if I can interrupt for just a
moment, I am going to need to leave because I am going to be in
a panel testifying before another committee, taking your place,
on a pension bill. I apologize, but I need to testify before
another legislative committee at this time, and I look forward
to reading the testimony of those that I do not hear today, and
working with everybody here.
Chairman Johnson of Connecticut. Thank you. I have to say
the bill that Ben and my colleague, Rob Portman, are proposing
will have as much to do with helping to create economic
security for some of these young girls as anything this
Congress might do by allowing and encouraging employers, even
those who provide minimum wage benefits to their employees, to
also be able to provide pension opportunities and encourage
savings.
Thanks, Ben.
Pat Funderburk.
STATEMENT OF PAT FUNDERBURK WARE, PRESIDENT AND CHIEF EXECUTIVE
OFFICER, PRESERVING FAMILY WELL-BEING FOUNDATION, ASHBURN,
VIRGINIA
Ms. Ware. Good morning.
Chairman Johnson of Connecticut. I'm sorry, Pat Ware.
Ms. Ware. Pat Funderburk Ware, but it is not hyphenated,
and Ware is so much easier than Funderburk, so I just use the
Ware.
I am now serving as president and CEO of Preserving Family
Well-Being Foundation, a new nonprofit organization formed by a
number of African American organizations around the country
that are also very interested in the issue of teen pregnancy
prevention and family preservation. And much has been said that
I do agree with, coming onto the Hill, Isabel Sawhill, one of
my colleagues. I agree that teen pregnancy prevention is
extremely critical.
I will tell you, if you are looking for my testimony it is
not there. It is not there because I have been in the field for
the last 2 weeks talking about this issue in the communities,
in rural area, urban areas, and actually forgot that I was
supposed to be here today. So it was fortunate I got home at 1
a.m. and looked at my other calendar and saw this. But again,
it was a good thing to do because it does lead up to what we
are talking about today.
I think I heard earlier from Dr. Zill about the importance
of adults being involved in this conversation. We are talking
about, how do we actually prevent teen pregnancies? One of my
focused areas is the adults. I don't do a lot of discussion and
training with the young people because, for many reasons, I
feel this is more of an adult problem than a teenager's
problem.
I have been invited by communities that do have title V
money to come in and do what we call community training, and I
do title training--is there hope for them, because the focus in
most of the communities is on the African-American community;
and we have seen the data, and I have been very encouraged by
the response that we have gotten because what I try to help the
community do is to take a journey with me, to do something
really different, not just focus on what the kids are doing,
but what we as adults have and have not done? Why is it that at
a time in the history of African Americans in this country,
where we can have more economic and educational opportunities
than we have ever had, that the data for our youth looks worse
than it has ever looked since we have been in America?
And we talk about that, how did we get from point A to
point B? How is it that at the onset of 1960 nearly 80 percent
of all black households were headed by two parents. And now we
have heard the data today; it is horrendous.
So what I found in the community is that we don't have to
talk about political issues. We don't have to talk about
abstinence versus contraception. We talk about what we can do
as a people. What happened to us? Did we abandon the values
that kept us together as a people through slavery and
segregation, Jim Crow-ism and hangings, and we look at those
values, and it is very clear, once we assess what we did, what
changed after integration that is very clear, that we don't
teach our kids the same things anymore. We don't talk about
delaying sex, waiting until marriage. We don't have a strong
value on marriage any longer.
I talked to them about the data that is out there, about
the health data study that came out, that was funded by the
National Institutes for Child Health and Human Development,
that looks at what keeps our kids safe, and when they looked in
the area of pregnancy and sexuality, there were four strong
points that they talk about in this report.
The first is the connectedness with parents, how many of us
are connecting with our parents. The second is when a parent
gives a child a very clear, clear message that they do not want
that child to be sexually active, not a kind of nondirective
kind of wishy-washy response. The third that I think surprised
a lot of us is when the parents give a clear message that they
do want their children to use contraception, and what also was
surprising in this study was that 10 percent of the men, young
men, I think, between the ages of either 14 or 15 and 19 in
this study, over 12,000 of them and 15 percent of the young
women had taken pledges of chastity, and that was a surprise to
many people.
But what we are trying to do is to paint a vision for our
people about what it can be like for us in the future, what our
families could look like and how do we get there; and it is
clear that we can't get there by not being very clear what we
want our kids to do and how to do that.
I was a single mom myself for 20 years. I have lived in a
devastated inner city community and helping revitalize that
community so the teen pregnancies rates would decline, and drug
abuse. And people started their own businesses and bought homes
that they thought they would never have, got off welfare and
stayed off welfare, and it is more than a discussion about
whether we should teach abstinence or use contraception.
And when we can paint the vision, what I have found in
every community I have been in, whether poor rural or urban,
the conclusion from the parents is always that we have to teach
our children something better, we have to teach them about
delaying sexual self-gratification, and we have to help them
understand why sexual activity is not in their best sexual
interest, best health interests for the present or the future.
There is a lot more I can say, too, but I do see the red
bulb, and I will stop.
Chairman Johnson of Connecticut. Thank you very much, and
thank you for being here. Certainly, your experience in the
field is extremely important to us because you can talk all you
want about the stuff in Washington, frankly, and if you never
get out there to the real world and if nobody ever hears you,
it isn't going to make a bit of difference.
Mr. Richards.
STATEMENT OF CORY L. RICHARDS, VICE PRESIDENT FOR PUBLIC
POLICY, ALAN GUTTMACHER INSTITUTE
Mr. Richards. Thank you. We have been hearing this morning
that nonmarital childbearing is an exceedingly complex problem,
and it is, but certainly one of the driving forces behind
nonmarital childbearing in the United States is unintended
pregnancy. Among all the births to never-married women in the
United States, 6 in 10 are the result of pregnancies that were
not intended. Among teenage births, and teenagers are
overwhelmingly not married, two-thirds of the births are the
result of unintended pregnancies.
So clearly, as we look at a range in societal responses to
the problems of nonmarital childbearing, we need to pay
attention to unintended pregnancy.
The second point I would like to make is that unintended
pregnancy is not an intractable problem. We have heard this
morning, and I absolutely agree, that the rates in the United
States are high. They are very high compared to other developed
countries; they are far too high. But the fact of the matter is
that rates of unintended pregnancy in the United States have
been coming down. They have been coming down for all women,
including adult women, and especially for teenage women.
I think we have heard twice this morning that teenagers are
not responsible for the bulk of nonmarital childbirths in the
United States, and I want to say it for the third time.
Teenagers only account for about a third of the nonmarital
childbearing in the United States, but for reasons given by
Isabel Sawhill and others, there is plenty of justification for
dealing with the problems of our young, most vulnerable
citizens, so addressing teenage pregnancy is a tremendously
important problem.
Having said that teenage pregnancy rates are coming down in
the United States, that naturally raises the question that all
you policymakers want the easy answer to, which is why; and of
course, I can't give you the easy answer because there is much
that we don't know about why people are behaving the way they
are. But there are new data from the National Surveys of Family
Growth in 1988 and 1995 that shed some light on what is sort of
the first-cut question, which is, how much of this is due to
increased abstinence among teenagers and how much is due to
other factors?
What we have seen from the NSFG surveys is that between
1988 and 1995 there was a 10 point decline in the teenage
pregnancy rate from 111 to 101 per 1,000 teenagers. During that
same period there was a 2 percent decline in the proportion of
teenagers who reported that they ever had intercourse. But
while statistically that is very small, the fact of the matter
is that that 2 percent decline in sexual activity is
responsible for about 20 percent of the total decline that we
have seen in teenage pregnancy.
What that means, however, is that 80 percent of the decline
has to do with changes in behavior among teenagers who are
sexually experienced, who have had intercourse in the past; and
we looked at the three possibilities that could be responsible
for that. It could be one or a combination, of either sexually
experienced teenagers having sex less frequently, using
contraceptives more in total, or using contraceptives more
effectively. What the data seem to show is that sexually
experienced teenagers are not substantially less sexually
active than in the past. Meanwhile, their total contraceptive
use has gone up only very slightly, from about 78 percent to 80
percent. But the real change, and the significant change that
is responsible for the very steep declines that we have seen in
pregnancy rates among sexually active teenagers, is a change in
method use primarily toward the new long-lasting hormonal
methods, Depo-Provera and the contraceptive implant Norplant,
which only came on the market in the United States in the early
1990s.
By 1995, the second NFSG survey, 1 in 10 teenagers at risk
of unintended pregnancy was using these methods, and we think
that that is the critical reason that pregnancy rates among
sexually active teenagers went down.
Earlier, Stephanie Ventura talked about the very steep
decline we have seen in second pregnancies to teen moms, and it
would appear that the use of these long-lasting contraceptives
is even more important among these teenagers because about one
in four of these teenagers is using these methods.
So, to sum up, it seems to me that in the great controversy
over whether this is due to abstinence or contraception, it is
not an either/or situation, that both seem to be at play here,
though not in the same proportion; and I would suggest that the
policy implications of that are relatively clear, or they seem
relatively clear to me, which is that even as we continue to
promote abstinence with our young people, we need to recognize
that half of the teenagers in the United States still are
sexually active and that access to the information and the
contraceptive services that they need to protect themselves
need to be preserved as well.
Chairman Johnson of Connecticut. Thank you. That was very
interesting, and it does remind us that this is a complicated
problem and certainly contraception plays a role.
[The prepared statement follows:]
Statement of Cory L. Richards, Vice President for Public Policy, Alan
Guttmacher Institute
Good morning. My name is Cory Richards, and I am Vice
President for Public Policy at The Alan Guttmacher Institute
(AGI), an independent, not-for-profit corporation for
reproductive health research, policy analysis and public
education. In compliance with clause 2(g)(4) of House Rule XI,
I have submitted to the subcommittee information on relevant
federal government grants received by AGI.
Thank you, Madam Chairwoman, for inviting me to speak to
you and members of the subcommittee this morning as you
consider a range of questions related to the goal of reducing
nonmarital births.
Nonmarital childbearing in the United States is an
exceedingly complex matter; it represents the coming together
of a variety of factors. But no matter how you cut it, one
central force driving nonmarital birth is unintended pregnancy.
Fully six in 10 births to never-married women are the result of
pregnancies that were unintended. Among teenagers, most of whom
are unmarried, fully two-thirds of all births are the result of
pregnancies that were unintended.\1\ As a result, although
there are many ways in which we, as a society, can work to
alleviate problems associated with nonmarital births, it is
clear that confronting the issue of unintended pregnancy is
absolutely critical.
---------------------------------------------------------------------------
\1\ Source: Henshaw S, Unintended pregnancy in the United States,
Family Planning Perspectives, 1998, 30(1):24-29.
---------------------------------------------------------------------------
In that light, it is heartening to be able to report that
there is some very good news on the unintended pregnancy front:
Unintended pregnancy rates in the United States began to
decline over a decade ago, and that decline has continued into
the 1990s. Indeed, the unintended pregnancy rate among all
women of reproductive age dropped fully 16% between 1987 and
1994.\2\
---------------------------------------------------------------------------
\2\ Source: Ibid.
---------------------------------------------------------------------------
On the teenage pregnancy front, the news is especially
good: After years of steady increases, U.S. teen pregnancy
rates have dropped markedly this decade. Teen pregnancy rates
peaked in 1990, and then fell 17% between 1990 and 1996.
Likewise, teen birthrates have fallen off since 1990,\3\ and
teen abortion rates fell by almost a third between 1986 and
1996.\4\ While, contrary to popular belief, teens do not
account for the majority of nonmarital births,\5\ childbearing
among unmarried young women is quite properly of particular
concern to us all, since young mothers and their children are
especially vulnerable to severe adverse social and economic
consequences.\6\
---------------------------------------------------------------------------
\3\ Teen birthrates dropped 12%, from 62.1 to 54.4 per 1,000,
between 1991 and 1996. In 1986, the birthrate was 50.2. Source: The
Alan Guttmacher Institute (AGI), Teenage pregnancy, overall trends and
state-by-state information, New York: AGI, 1999.
\4\ The teen abortion rate was 42.3 in 1986; in 1996, it was 29.2.
Source: Ibid.
\5\ Nonmarital births to teenagers account for 31% of all
nonmarital births. Source: Ventura, SJ et al., Births: Final data for
1997, National Vital Statistics Report, 1999, Vol. 47, No. 18, Tables 2
and 17.
\6\ See Maynard RA, ed., Kids Having Kids: A Robin Hood Foundation
Special Report on the Costs of Adolescent Childbearing, New York: The
Robin Hood Foundation, 1996.
---------------------------------------------------------------------------
Why have teen pregnancy rates fallen? Answers to this
question are crucial, as they can--and should--inform how we
can sustain these positive trends among teenagers, as well as
shed much-needed light on ways to address the phenomenon of
unintended pregnancy that is shared by women of all ages.
Careful analyses of key government data \7\ indicate that
approximately 80% of the declines that we have seen in teen
pregnancy can be attributed to declines in pregnancy rates
among sexually experienced teenagers. Indeed, the drop in
pregnancy rates among sexually experienced teens has been very
marked--16% between 1990 and 1996.\8\
---------------------------------------------------------------------------
\7\ The 1988 and 1995 National Surveys of Family Growth.
\8\ In 1990, the pregnancy rate among sexually experienced teens
was 224; in 1996, it was 190. Source: Saul R, Teen pregnancy: Progress
meets politics, The Guttmacher Report on Public Policy, 1999, 2(3): 6-
9.
---------------------------------------------------------------------------
Declining pregnancy rates among sexually experienced teens
must be attributable to one or more of the following three
factors:
less frequent sexual activity;
an overall increase in contraceptive use (that is,
an increase in the proportion of sexually experienced teens
using a contraceptive);
and/or improved--in other words, more effective--
contraceptive use.
Government data do not bear out a decrease in levels of
sexual activity among sexually experienced teens.\9\ On the
other hand, there is evidence that a slightly larger proportion
of sexually active teens are using contraceptives,\10\ and--
even more significantly--that teens who do use contraceptives
are using more effective methods. Most notably, there has been
a substantial shift among sexually active teens toward use of
highly effective, long-acting contraceptive methods--the
contraceptive injectable, Depo-Provera and the contraceptive
implant, Norplant. These methods only hit the U.S. market in
the early 1990s, but by 1995, one in ten sexually active teen
women at risk of unintended pregnancy was using one of
them.\11\ Because these long-acting methods are so effective
and so easy to use, they are making a big dent in the teen
pregnancy rate.
---------------------------------------------------------------------------
\9\ A somewhat lower proportion of sexually experienced young women
reported having had intercourse in the three months prior to the
National Survey of Family Growth in 1995 than in 1988 (79% vs. 81%);
however, over the entire prior year, sexually experienced young women
reported having had intercourse during the same average number of
months in both the 1988 and the 1995 NSFG (8.6 months). Source: Ibid.
\10\ A greater proportion of sexually experienced teens reported
currently using a contraceptive--using one within the last month--in
1995 than in 1988; that number grew from 78% to 80%. Source: Ibid.
\11\ Source: Ibid.
---------------------------------------------------------------------------
Use of Depo-Provera and Norplant may have played a
particularly large role in reducing second pregnancies among
teen mothers. Data released earlier this year by NCHS showed a
dramatic 21% decline between 1991 and 1996 in the proportion of
teens giving birth a second time.\12\ During a corresponding
time period, as NCHS researchers have pointed out, a relatively
high proportion of teen mothers--one in four--were using long-
acting methods.\13\
---------------------------------------------------------------------------
\12\ Source: Ventura SJ, Mathews TJ and Curtin SC, Declines in
teenage birth rates, 1991-1997: National and state patterns, National
Vital Statistics Reports; 1998, Vol. 47, No. 12.
\13\ Using data from the 1995 National Survey of Family Growth,
NCHS researchers estimate that about one-fourth of teens who are
mothers are using Depo-Provera or Norplant. Source: NCHS, Unpublished
tabulation, 1999.
---------------------------------------------------------------------------
Our analyses additionally confirm that there has been a
decline--or at least a leveling off--in the proportion of
teenagers who have ever had sexual intercourse. Indeed, the
proportion of women aged 15-19 who report they have ever had
sexual intercourse decreased about one percentage point between
1988 and 1995.\14\ About 20% of the declines in the overall
U.S. teen pregnancy rate is attributable to this increased
abstinence.
---------------------------------------------------------------------------
\14\ The percentage of 15-19 year old women who say they have ever
had sexual intercourse was 52.6% in 1988 and 51.5% in 1995. Source:
Saul R, 1999, op. cit. (see reference 8).
---------------------------------------------------------------------------
Many questions remain around why teen contraceptive use has
improved, and why more teens are remaining abstinent, but the
bottom line is that both phenomena are making a difference in
combating teen pregnancy. As we have seen, about 20% of that
difference is attributable to increased abstinence; about 80%
is due to more successful pregnancy prevention efforts among
teens who are sexually active. This strongly suggests that even
as abstinence is being promoted to our nation's young people,
access to contraceptives for those teens who are sexually
active--half of all U.S. teens--is also vitally important to
reducing teen pregnancies, fully eight in 10 of which are
unintended.\15\
---------------------------------------------------------------------------
\15\ Seventy-eight percent of pregnancies among 15-19-year-old
women are unintended. Source: Henshaw S, 1998, op. cit. (see reference
1).
---------------------------------------------------------------------------
In fact, access to highly effective contraceptives can--and
clearly does--make a difference in reducing unintended
pregnancy and, as a result, nonmarital births among all women.
Since low-income women are especially vulnerable to unintended
pregnancy and nonmarital childbearing, government-subsidized
family planning services are key to addressing these issues. I
applaud the efforts of committee members who worked to ensure
that TANF funds can be used for family planning services. The
unmet need is great,\16\ and new funding under TANF is a small
but important step in the right direction.
---------------------------------------------------------------------------
\16\ An estimated 16.5 million women in the United States are in
need of publicly subsidized contraceptive services. That is, they are
sexually active, fecund, not pregnant and not trying to become
pregnant, and are either teenagers or have a family income below 250%
of the federal poverty level. Only 27% of women in need of such
services are married. Of those who need publicly funded services, it is
estimated that four in 10 women were served by a public family planning
clinic in 1995. Source: AGI, Contraceptive Needs and Services, 1995,
New York: AGI, 1997.
---------------------------------------------------------------------------
Thank you.
Chairman Johnson of Connecticut. I did want to ask Mr.
Rector, though, about his interest in abstinence programs. I,
too, am very interested in abstinence programs, and as
impressed as I am with the Best Friends program--and I haven't
been out there to visit, I just read about them--I have to tell
you that there is a program that my hometown has had over
either 6 or 8 years--I can't remember how long the program has
been in place, and unfortunately, its structure was not able to
come today, but they have had one pregnancy over all the area
through the years, and that pregnancy was by a male who had
dropped out of the program 2 years earlier.
But their commitment to these kids is, once you are in, you
are always in, and you are always our person and we count you
in our statistics, which I think is a very high standard. And
it is very interesting to me because they absolutely stress
abstinence, but they also teach sexual health, I mean personal
health, and they also teach about contraceptives; and they
don't have a problem with this mixed message stuff, but I think
it is because they do it regularly over time. It is a very
normal part of the conversation.
The kids hear things on the street, they can bring it back.
They hear things in school, they can ask about it. And they
don't qualify for $1 of Federal money because they aren't
sufficiently pure, but their record is better than any
abstinence program I am aware of.
So as much as I agree with you that abstinence has to be
talked about more and certainly, Ms. Ware, that is what you are
fighting is that we need to know how to talk to young people.
How do some of us grow up with that assumption? I mean, I can't
remember my parents ever talking to me about it, but I
certainly know what they thought about these things, and they
did influence not only my behavior, but every kid I knew. Of
course, that was helpful since there was more uniformity.
But would you support abstinence programs, abstinence
funding going to programs on the basis of their performance and
a little less on the basis of whether or not they teach about
contraceptives or don't teach about contraceptives?
Mr. Rector. I think there are a couple of points. First of
all, when people are looking at the pure abstinence programs
directed towards marriage, sometimes there is a suggestion that
we are trying to deny children information. In almost all the
schools where these programs, for example, the Best Friends
program, there is information about birth control provided in
some context in the school. It it not like we are going and
pulling books off the shelves and ripping pages out and things
like that.
What I feel is the most--what we see in these programs is
that the program providers have to believe in the message, and
what we were concerned about in drafting title V was that if
you allowed a simple mixed message, what we would get was the
same old sex ed program, but, where somebody puts the word
``abstinence'' on the front cover--actually--even with the
tight definitions in title V, we got more of that bogus
abstinence than we got real abstinence, I think. It is very
important that the presenter and the teacher really believe it,
because you are asking them to--.
Chairman Johnson of Connecticut. I appreciate that very
much, and I think when you first start something like this, you
have to be perhaps a little more focused than you do later on.
But what would be wrong now with a program that has been
established and that can demonstrate highly effective
abstinence performance, why would we need then to be quite so
judgmental in exactly how they do it? Clearly, they are
committed to the message of abstinence, there is no question
about it; but by having them both in the same place, as opposed
to someplace else in the school, the trust issue is very, very
great--what can we ask, and whom can we trust to talk to us
straight--and I would hope that you would think about whether
or not you and your organization would be willing to support a
certain portion of this money going on outcomes like that.
Mr. Rector. I think, first of all, still--even within title
V, I think that the predominant number of programs, despite the
rigor of the definitions in those programs--and I am glad you
have got a program that is firmly committed to abstinence and
is communicating that message. I think that the majority of
title V programs really aren't committed to that; that would be
my experience. There are some very good ones out there. There
might be some good mixed message programs, but by and large,
even within title V, I think the abstinence component is quite
weak, and therefore, I think that that kind of change would be
premature.
I think the program that you are talking about could be
very well funded under other programs, but basically, I would
like to see most of the title V programs get up to speed.
Chairman Johnson of Connecticut. See, first of all, I would
have to say this: These kids live in a mixed message world, and
having a program that is not capable of talking about both is a
weakness.
But I certainly would hope that you would give some thought
to working with us on outcomes. I mean, the abstinence program
has been in place long enough now. Why can't we have a portion
of that money go to outcomes? Have you performed? Are your kids
abstaining?
So I think once a program's been in place a little longer,
then you are obliged to look at the outcome, and if you are
abstinence and you are talking abstinence and your rate of
pregnancy is high, you shouldn't get the money; I don't care
what you are talking about, you know.
So we will be looking at changing that language, but I
wanted you to understand that it was because I personally
believe that there are high-performing abstinence programs out
there, and that I have an obligation to make sure that the
money goes to help kids not get pregnant.
Mr. Rector. That would be fine.
I would also recommend, though, that in looking at
evaluations, we ought to evaluate title X and a lot of these
other programs which have been around much longer than title V,
have not been evaluated and are not rewarded by outcome. One of
the things we were trying to do with title V was to create some
diversity, because there really wasn't a lot of strong
abstinence, certainly not federally funded strong abstinence
out there, and my feeling is that if you weaken the definition
of that, far from creating, we would just fall back into----
Chairman Johnson of Connecticut. Oh no, I don't think we
are talking about weakening definitions. I think we are talking
about strengthening focus by looking at outcomes, not weakening
definitions. So I think we just have to recognize the
complexity of the problem and that programs that develop the
kind of trust you need amongst kids cannot be forbidden from
talking about the realities of those children's surroundings.
Mr. Rector. Again, I could--you know, I think we are both
aware that one of the strong potential problems here is what we
would end up with is a condom promotion program that has
abstinence tacked on the front end. And I think everyone agrees
here that the value base that is in the program that you are
talking about and the ones I am talking about is a critical
feature, and we wouldn't want to jeopardize that.
Chairman Johnson of Connecticut. We certainly don't, but we
do want to make sure that the programs that are working have
some support to expand.
Dr. Nathan--Mr. Nathan.
Mr. Nathan. I would like to make a comment about that. In
my testimony on page 9, the bottom of the page, I point out
that TANF and MOE funds--and there have been quite a few recent
reports that say this--can be used for other kinds of programs,
like the programs you are speaking about. I think that it maybe
isn't the law that needs to be changed, but there needs to be a
greater understanding of this.
A lot of people, I think, out in the country don't realize
that, and so that might be a way to educate without having to
legislate.
Chairman Johnson of Connecticut. Thank you. I do want to go
back to the issue in your testimony about connectivity and just
briefly ask you to comment on the apparent difficulty we are
having in Medicaid sign-ups and whether that represents sort of
a bureaucratic connectivity problem and whether there are ways
that we could better focus the welfare reform bureaucracy, as
it is evolving, to better connect with public health agencies
and, you know, the kinds of programs that could reach teens and
women on this issue of unmarried births.
Mr. Nathan. I appreciate the chance to comment on that.
It is not surprising that in delinking AFDC and food stamps
and Medicaid that we are seeing the kinds of effects that are
occurring. In my opinion, the key is that welfare reform is a
work in progress. The key to what happens is information
technology and building systems that workers at the front line
can use to make connections and track services--both services
and safety net programs. Right in this room last week, on
Friday, we held the fifth meeting of the Rockefeller Institute-
General Accounting Office ``Working Seminar on Information
Systems for Social Programs.''
I am not a techie, I don't do this stuff myself, but I
think this is the future in terms of what the new welfare
becomes. TANF is bigger than welfare. The challenge now is to
build systems. The young people who are being hired and work in
these bureaucracies aren't afraid of the technology. It is off
the shelf technology. The money is out there; there is a good
spirit about welfare reform now. It is not as controversial.
This is the moment, with the economy performing the way it
is, to put a lot of emphasis on making connections with
information systems that workers can use on the front lines for
health services, just as you said, and for safety net programs
and for job programs.
We had people from different States come and talk about
what is going on in the country. Like Diogenes with the
lantern, I have been out there looking for the best way to do
this. There are efforts going forward. I think this is the most
important finding of our research, namely about building
management systems with information technology where I think
the Federal Government can help. I have been going around in
Washington trying to urge Federal agencies and people around in
different key areas in Washington to support this. The staff of
this Subcommittee has been very active and helpful in this. In
fact, Comptroller General David Walker, who attended on Friday,
specifically thanked you for letting us use this room for our
meetings.
Chairman Johnson of Connecticut. I see from your larger
report on the 20 sites and I see in my own experience that the
better connection between the welfare eligibility bureaucracy
and the job training job placement bureaucracy is having a very
powerful effect. I don't see developing yet any healthy
connection between that bureaucracy and the substance abuse
prevention people, substance abuse treatment people, the mental
health resources are completely lacking. As we get more into
this, that is going to be very, very important, and then on
this issue of the means, the reasons for not having children
out-of-wedlock, not having that second birth, we are not
connecting well into the sort of information about that, why
you wouldn't do that, what it means for your future, what it
means for the child's future and what are your options.
Mr. Nathan. That is exactly right, and it is a big
opportunity, and wherever it is happening we should understand
that and use information about best practices to promote these
kinds of changes. It is really the future of the new welfare
right there.
Chairman Johnson of Connecticut. Yes, Ms. Ware.
Ms. Ware. Mrs. Johnson, I just wanted to make one quick
comment on your concern about perhaps opening the title V money
to organizations that also discuss contraception. I did a
manual on abstinence, an abstinence resource manual, looking at
all of the abstinence programs and what worked in these
programs, whether they had been evaluated and so forth. Many of
the very good programs do talk about contraception. I think it
is a misrepresentation that abstinence programs--abstinence
only programs don't mention contraception or condoms. They do.
Many of them do. But it is the way they are talked about, it is
in what context, and it in no way suggests to the young person
that sexual activity is an OK behavior if you think you are
mature enough or if you think it is your choice, that kind of
thing. It lets young people know that if this is what you will
do, and some kids are going to regardless of what you say, that
there still is a risk factor involved for you, and we spend
most of the time trying to help them understand why waiting is
better and then helping them develop the skills to do that,
give them something to look forward to in the future, those
kinds of things.
But there is a--the most serious difference between
programs that also provide contraception and consider
themselves abstinence-based and abstinence only is not that one
talks about contraception and the other doesn't. It is that
under no circumstances will the abstinence-only program
encourage sexual activity in any way. It is a fine point----
Chairman Johnson of Connecticut. It would be very hard to
see, you know, how they would oversee that. I mean certainly
there is no question in my mind, but there is this program at
home in my district that certainly has that message but they
have not received any abstinence money. Now, I don't know
whether it is the general suspicion that new England isn't
sufficiently morally straight, but I think that one way of
dealing with this problem, because it is very hard from the
outside to judge that, is to begin to look at outcomes data
when we have it.
Ms. Ware. Right.
Chairman Johnson of Connecticut. We do in every other area,
and it just blows my mind that we could ignore a program that
has had one pregnancy over 6 or 8 years from a kid who dropped
out. So I think that--I think we do have to look at a variety
of tools, and I think you can do that without diluting it, and
I think your comment about the fact that many of these
abstinence programs do also provide information that kids
really need to know or at least some kids need to know is
interesting.
Bell, did you want to comment?
Ms. Sawhill. Can I jump in, is this Pathways/Senderos, and
by the way it is a wonderful program, and we have written it up
in one of our national campaigns to prevent teen pregnancy
because one of the things that is needed when there are good
programs like this is other people around the country need to
know about them and be able to use them as models of best
practice.
Chairman Johnson of Connecticut. Just for a moment on that
issue, they are now seeing kids not able to come regularly to
their program because they have to stay home this summer and
take care of the children, their brothers and sisters, and the
neighborhood wants them to start a program for younger children
so they could have a summer program that would be totally
abstinence because these are under fifth grade. The fifth grade
teachers talked them into starting a fifth grade class, and
they have only had the kids for 3 months and their grades have
gone up and their behavior has improved. This is a very, very
successful program, but it doesn't--so there is something wrong
when you can't look at results.
Ms. Sawhill. I love your idea of a more outcome-based focus
for the use of these funds, and I think it is exactly the right
way to go. I think one of the problems with teenage pregnancy
prevention programs is they have not been adequately evaluated
in the past. We know far too little about how to achieve
success in this area, and as a result of that, we are, you
know, sort of flying blind.
Now, I am very pleased that you all did put some funding
for evaluating at least the abstinence-based programs into the
welfare reform amendments and that some of that is going on
now, and we all look forward to seeing the results, but I think
we need still more evaluation, and our advisory panel, which I
want to thank you for being a part of, by the way, to the
national campaign, has been looking at this issue, and the co-
chairs of that panel, as I think you know, Mr. Castle and Ms.
Lowey, have co-sponsored a bill that would call for more
outcome-based programs and more money for evaluation and then
funding of the ones that have been demonstrated to be effective
through those evaluations and spoken to some people on the
Senate side as well who are also interested in that. So I just
wanted to sort of flag that as being very consistent with I
think what your ideas are here.
I think what you say about what people on the ground are
going to do, what they think is best, is absolutely right as
well. I think it is very good that the Congress has changed the
debate, and I give my friend Robert and others in the
conservative community lots of credit for having changed the
discussion about these issues, but I think in the end when you
are talking about actual teachers and mentors and others in
local communities working with kids, they have to be given the
flexibility to work with those kids in whatever way they think
is effective.
I would point you to the example of South Carolina where
the legislature did allocate some funding for teen pregnancy
prevention last year, and they are putting the money out to all
of their local communities with complete flexibility in terms
of how the money is used, and it seems to me that, you know,
that is the model we have to build on. We have to change the
conversation about this, but in the end, we have to give the
people who are actually running the programs a fair amount of
flexibility.
Chairman Johnson of Connecticut. I do think it is very
important, and certainly my goal is not to substitute the
legislation that has been introduced as interesting, as I think
it is, for the language in there. I think it is just that you
want to create also a way in which programs can be viewed by
the accomplishments they have achieved, but I do just want to
mention one other fact.
When you look behind any of these programs, and they are
providing role models. They are helping kids with their
homework. They are giving kids some view of other career
options. You know, they are not succeeding on the issue of
abstinence on simply moral authority ground. They are
connecting not having children with having power over your life
and opportunity, and that is I think why the message succeeds.
So as important as the issue of abstinence and/or
contraceptives is, the real power of these programs is that
they help kids do better in school. They give them an
alternative to unstable homes often, often though not always,
and they give them a way to see what else they could do in life
besides go on welfare.
Mr. Rector. If I could just reinforce the one point that
Dr. Nathan made that I thought was very important vis-a-vis
your program, all the TANF surplus funding in the State could
be used for that program.
Chairman Johnson of Connecticut. I appreciate that. For me
it is a matter of principle, Mr. Rector. I think since they are
focused on this they are serious about abstinence, and they are
performing, and they are having great results. So I think for,
``abstinence funding to cut them out is simply wrong,'' see.
So, yes, there are other sources. I mean, they have been up and
running and they have gotten national attention, but I don't
think it is right, and I appreciate your point that you don't
want to--you fear dilution and you----
Mr. Rector. Dilution is already here.
Chairman Johnson of Connecticut [continuing]. Fear under
the original law that you would have just simply rubber stamped
old programs with a new name, but I don't think that relieves
me of the responsibility to really look at programs that focus
on abstinence, that achieve abstinence but may not, for
microtechnical reasons--see, it is very judgmental when you get
down to this level of are they talking about contraceptives or
are they not and what is their intention in talking with them.
So this is really bad territory. The Government really can't
evaluate that. So I have to look more closely at that law, and
we certainly would keep you informed. I just wanted to alert
you to the fact that I do think outcomes matter a lot, and some
of the programs that are working really hard at abstinence in
the very heart of poor urban areas and succeeding, they deserve
recognition.
Mr. Rector. I think it is important to realize that title V
represents only a very, very small fraction of the amount of
money that the Government is spending on sex ed and only a
small fraction of title V is going to abstinence-only programs.
We were trying to break the mold and to move, particularly
public health institutions, in a new direction. If we are going
to go with--outcome-based funding and things like that, I think
it is very important to look at all the sex ed funding that is
coming out of HHS and not just title V.
Title V is a brand new program. We now have better
evaluations on title V than we do on all the bulk of the other
programs that have been around for decades. I would commend to
you a very important thing that we could do is call for the
same sorts of evaluations on title X and other sex ed programs
or abstinence-plus programs. In the long run, we want the same
thing that you do. I am just afraid of the bureaucratic
inertia. If we didn't clearly say we want you to do something
different--the bureaucracies in the State level are very, very
hostile to abstinence-only. So if we drop the strict
definition, I think most abstinence-only programs would vanish.
We wouldn't even get to experiment, we wouldn't get to evaluate
abstinence only because the programs wouldn't exist, and that
was our concern.
Chairman Johnson of Connecticut. Yes, Mr. Richards, then we
must go on to the next panel.
Mr. Richards. I would just like to make the point that
title X is not a sex education program. It is a family planning
services program. Two-thirds of the clientele in family
planning clinics are adults, in addition to which there have
been many evaluations of the program over the years in terms of
its impact on preventing pregnancies.
Chairman Johnson of Connecticut. I would just say that in
my district, which is really, I mean my biggest city is 65,
70,000, it is going down so I never quite know, title X and
some of the poor cities in my district where they have no
community health centers, they were the only access women had
for pap smears, but family planning is very important to
married couples. Married couples need to be able to have the
number of children they want to have, and they should not be in
a position of having to decide about whether to have an
abortion or not.
I mean, my husband in the early days when abortions were
illegal stood at the bedside of a mother of five with a husband
standing there, and she died of an aseptic abortion, and she
died because they could not tolerate the economic burden of one
more child, and they had not been able to prevent the
pregnancy. So that was a part of life at that time, and as much
as I think we need to retrain our children and ourselves as
adults and do something about the mixed messages out there and
this terrible problem of children being born in circumstances
that do terribly prejudice that child to destitution and
failure, I also think the lack of healthcare for uninsured
women, the terrible importance in a free society of being able
to control whether you have more children or not is something
that unfortunately title X has been a weak small lever, but it
has been all we have been able to do, and I think the issue of
teen pregnancy is really a different issue and we need to think
about it and act on it far more aggressively than we have. I
think it is the one area in which there is consensus, and we do
need to work more effectively, and we have some better
information now from the abstinence program.
The Alan Guttmacher Institute
Washington, DC, July 20, 1999
The Honorable Nancy L. Johnson,
Chairman, Committee on Ways and Means
U.S. House of Representatives,
Washington, DC.
Dear Madam Chairman:
This is in response to your request for additional information
concerning the calculations that led to our conclusion--presented by
Cory L. Richards, The Alan Guttmacher Institute's (AGI) vice president
for public policy, in his testimony before the Subcommittee on June
29--that, to varying degrees, both increased abstinence from sexual
activity among teenagers and changes in contraceptive behavior among
sexually experienced teenagers contributed to the observed decline in
the pregnancy rate among U.S. teenagers between the late 1980s and the
mid-1990s.
These calculations, which are detailed below, were based on the
following data sets:
Pregnancy rates--released by AGI in April, 1999 in
``Teenage Pregnancy: Overall Trends and State-by-State Information''--
are based on birth rates from the National Center for Health Statistics
and abortion data from periodic AGI Abortion Provider Surveys.
Information on the proportions of young women who have had sexual
intercourse are from the National Center for Health Statistics' 1988
and 1995 National Surveys of Family Growth (NSFG).
Information on sexual activity and contraceptive use is
from the 1988 and 1995 NSFG.
Overall contraceptive failure rates are based on NSFG
information on contraceptive use and from first-year failure rates
calculated from the 1995 NSFG and the 1994-95 AGI Abortion Patient
Survey http://www.agi-usa.org/pubs/journals/3105699.html).
In 1988, the pregnancy rate was 111.4 per 1,000 women aged 15-19,
and 52.6% of women aged 15-19 had had sexual intercourse, for a
pregnancy rate per 1,000 women aged 15-19 who ever had sex of 211.8
(.526 * 211.8 = 111.4). In 1995, the pregnancy rate was 101.1 per
1,000, and 51.5% of women aged 15-19 had had sex, for a pregnancy rate
per 1,000 women aged 15-19 who ever had sex of 196.3 (.515 * 196.3 =
101.1).
Between 1988 and 1995, the pregnancy rate per 1,000 women 15-19
declined by 10.3 pregnancies per 1,000 women, from 111.4 to 101.1. The
relative contributions to this decline from the change in the
proportion of women aged 15-19 who ever had sex and from the change in
the pregnancy rate among those who ever had sex can be determined by
calculating what the pregnancy rate in 1995 would have been if only one
of these factors changed.
If only the proportion of women who ever had sex had decreased
(from 52.6% in 1988 to 51.5% in 1995), given the pregnancy rate of
211.8 per 1,000 sexually experienced women aged 15-19, the overall
pregnancy rate per 1,000 women aged 15-19 in 1995 would have been 109.1
(.515 * 211.8 = 109.1). The pregnancy rate would then have fallen by
only 2.3 pregnancies per 1,000 (from 111.4 to 109.1). Thus, roughly 20%
of the actual decrease of 10.3 pregnancies per 1,000 (2.3/10.3 = 22%)
was due to the lowered proportion sexually experienced.
Similarly, if the proportion of women aged 15-19 who ever had sex
had stayed stable at the 1988 level of 52.6%, and only the pregnancy
rate among sexually experienced women aged 15-19 had fallen (from 211.8
in 1988 to 196.3 in 1995), the overall pregnancy rate in 1995 would
have been 103.3 (.526 * 196.3 = 103.3). This decrease of 8.1
pregnancies per 1,000 due to the lowered pregnancy rate among sexually
experienced young women is roughly 80% of the observed decline in the
pregnancy rate per 1,000 women 15-19 (8.1/10.3 = 79%).
The question, then, is how the decrease in the pregnancy rate among
sexually experienced young women occurred. Three factors were
investigated--whether these women reduced the frequency with which they
had intercourse, increased their use of contraceptive methods or became
more effective users of contraceptives.
Regarding the first factor, changes occurred between 1988 and 1995
in the sexual activity of women aged 15-19 who ever had sex, but they
offset each other so that there was no change in the average number of
months in the prior year during which sexually experienced women aged
15-19 had had intercourse (8.6 months in both years).
Regarding the second factor, contraceptive use at first intercourse
increased substantially between 1988 and 1995, but ongoing use at the
time women aged 15-19 were surveyed increased only slightly, from 78%
to 80% of women aged 15-19 who were having sex, fertile and not
pregnant, postpartum or trying to become pregnant.
Regarding the third factor, there were important shifts in the
types of methods used. Condom use increased slightly, and reliance on
oral contraceptives declined substantially. At the same time, however,
long-acting methods, such as the injectable and implant which were not
available in 1988, accounted for 14% of current method use in 1995.
Because of this shift to long-acting methods, the estimated overall
first-year method failure rate for teen contraceptive users dropped 9%,
from 16% to 15%.
The observed decline in the pregnancy rate among sexually
experienced teens appears to be attributable to these two changes in
contraceptive use, the modest increase in the proportion of users and
the substantial decline in their overall failure rate.
We hope this information will be helpful to you. It will be
expanded upon and placed in a larger context in a monograph to be
published this fall, and we will be certain to sent you a copy at that
time.
Sincerely,
Jacqueline E. Darroch, Ph.D.
Senior Vice President and
Vice President for Research
I am sorry to take so long. We really must be on to the
next panel, but thank you very much for your participation and
your help, and I look forward to working with you.
Brenda Miller, who is deputy director of the National
Campaign to Prevent Teen Pregnancy of the Urban Institute;
Rebecca Maynard, the project director for the National
Evaluation of Title V Abstinence Education Programs,
Mathematica Policy Research; Edward Tetelman, the assistant
commissioner of the New Jersey Department of Human Services;
and John Sciamanna, senior policy advocate in the American
Public Health Services Association.
We welcome you here today. I very much appreciate your
participation. I am very pleased to have Rebecca Maynard here
and her evaluation of the title V programs and would ask Ms.
Maynard to start.
STATEMENT OF REBECCA A. MAYNARD, PROJECT DIRECTOR, NATIONAL
EVALUATION OF TITLE V ABSTINENCE EDUCATION PROGRAMS,
MATHEMATICA POLICY RESEARCH, INC., AND UNIVERSITY OF
PENNSYLVANIA
Ms. Maynard. Thank you, Madam Chair. It is a real pleasure
to be able to talk with you about the ttle V abstinence
education programs and the lessons that should be coming from
the congressionally authorized evaluation of these programs.
As project director for the National Evaluation of Title V
Abstinence Education Programs, I have had the privilege of
seeing firsthand a number of quite exceptional programmatic
initiatives aimed at addressing head on the issues of teenage
sex and out-of-wedlock childbearing through abstinence only
education programming. Our mission in the evaluation is to
identify effective, replicable abstinence education models, and
as many of you know, there is a wide range of programs being
supported through section 510 of title V.
The funded activities out there range from State level
media campaigns to high intensity, multifaceted, multi-year
youth development initiatives. A handful of the States have
opted for a single statewide intervention strategy, but most of
the States have chosen to fund a diverse set of initiatives
ranging from brief curriculum-based classroom programs that are
offered communitywide to more extensive targeted classroom
programs that are complemented by strong boosters that
reinforce the abstinence messages and that provide youths with
alternatives to high-risk behaviors.
Many States also have supported some communitywide
initiatives that are using abstinence-only messages in an
effort to alter youths' behaviors through systemic changes in
community norms and opportunities and the support structures
available.
Now, I can't speak to the overall implementation of the
title V abstinence education program. However, in the course of
our preliminary evaluation work we have observed a wide range
of the programs that are out there funded under this
legislation, and I am going to just illustrate with five
programs some of the efforts that we have observed.
There is a locally-funded--locally-designed program in
Florida that has developed an abstinence only curriculum
offered to youth in grades 6 through 12 as a year-long elective
class. The class meets 5 days a week. Students receive
unequivocal messages about the value of abstinence, the power
of building positive relationships and the strong benefits of
marriage. These classroom curricula activities are reinforced
and extended to encourage parent support through regular home
visits by trained social workers.
Another program that we have spent time with is a very
intensive program operating in New Jersey that follows a
leading national abstinence education program model. This is a
school-based program that provides girls with between 100 and
200 hours of interaction with responsible adult mentors, most
of whom are teachers. This intervention extends over a minimum
of 3 years. In addition, the program includes health and
fitness components, and it offers a structured curriculum
covering topics such as friendship, decisionmaking, love and
dating, self-respect and substance abuse. So it is fairly
broad-based.
In several Wisconsin middle schools there is a program that
works with youth for 2 hours every day after school. This
program delivers strong abstinence messages in every one of
these after school sessions through a variety of means,
including through a formal curriculum that emphasizes knowledge
of anatomy, that provides information about sexually-
transmitted diseases and talks a lot about the values of
marriage. It also offers positive skill building activities
such as job shadowing and exposure to cultural events. Youth
generally stay in this program throughout the middle school
years once they come in, and many of the kids have an
opportunity to enroll in the summer program which lasts 7
weeks. Kids are in the summer program all day, every day, 5
days a week, again getting more of the abstinence curriculum,
more of the youth development activities and the strong
abstinence messages.
Virginia has a program for eighth and tenth graders that
uses a nationally marketed abstinence education curriculum. The
program classes, which meet about 30 times a year, address
abstinence in the context of a curriculum that is strongly
focused on character development. The school-based abstinence
education efforts are bolstered by media campaigns, an
information and referral service and communitywide workshops on
various aspects of parenting, youth development and abstinence.
The final example I will give you is Texas, which has a
communitywide initiative that is reaching students in more than
two dozen school districts with a national abstinence education
curricula. This program has trained nearly 200 teachers to
deliver the school-based curriculum. It engages physicians and
counselors to staff hotlines where they answer questions about
sexually transmitted diseases and other health risks associated
with teen and out-of-wedlock sex. It produces and airs media
spots. It has developed and administered tools to train medical
professionals in the promotion of abstinence. It has organized
community mentoring programs for youth, and it has instituted a
monitoring and assessment effort to help guide its community
efforts.
The evaluation that we are working on is going to
capitalize on the breadth and depth of programming that is
being supported through title V abstinence education to provide
much needed evidence regarding the potential of these various
programs. Moreover, the evaluation is going to focus on models
that are adaptable to different circumstances, for example, for
communities that are willing to institutionalize programs in
schools versus those that are only going to institutionalize
programs in the community setting or in after school settings.
In the evaluation, we have committed to the most rigorous
standards for conducting our studies. We are going to rely on
experimental design studies with large samples of youth to
document the impacts of the various programmatic strategies on
youths' behaviors, their knowledge and their attitudes. Then,
we are going to complement the rigorous impact analysis with
extensive qualitative research so that we can document the
nature of the interventions, the circumstances and strategies
for their successful replication and the mechanisms through
which the programs can strengthen family values and responsible
decisionmaking.
Thank you.
[The prepared statement follows:]
Statement of Rebecca A. Maynard, Project Director, National Evaluation
of Title V Abstinence Education Programs, Mathematica Policy Research,
Inc. \1\ and University of Pennsylavinia
The Personal Responsibility and Work Opportunity
Reconciliation Act (P.L. 104-193) authorized federal
expenditures of $50 million annually for five years beginning
in fiscal year 1998 to support state efforts promoting
abstinence-only education. A congressionally authorized
evaluation is now underway, funded through the Office of the
Assistant Secretary for Planning and Evaluation within the U.S.
Department of Health and Human Services.
---------------------------------------------------------------------------
\1\ University Trustee Professor of Education and Social Policy at
the University of Pennsylvania and Project Director for the National
Evaluation of Section 510, Title V, Programs being conducted by
Mathematica Policy Research, Inc., and the University of Pennsylvania
(HHS-100-98-0010).
---------------------------------------------------------------------------
As Project Director for the National Evaluation of Title V
Abstinence Education programs, I and my colleagues have had the
privilege of seeing firsthand a number of quite exceptional
programmatic initiatives aimed at addressing head-on issues of
teenage sex and out-of-wedlock childbearing. Our mission in the
evaluation is to identify effective, replicable abstinence
education models that are funded under the recent welfare
reform legislation. Toward this end, we have examined numerous
local program initiatives for the purpose of identifying
criteria by which to select sites. We are presently working on
selecting a focal group of well-grounded, well-implemented
projects for in-depth evaluation to document their efficacy in
delaying sexual activity among teens and in promoting
abstinence until marriage.
There is a wide range of programs being supported through
Section 510 of Title V. Funded activities range from state-
level media campaigns to high-intensity, multifaceted and
multiyear youth development initiatives. A handful of states
have opted for a single statewide intervention strategy, but
most have chosen to fund a diverse set of initiatives. These
initiatives range from brief, curriculum-based classroom
programs that are offered community-wide, to more extensive
classroom programs complemented by strong ``boosters'' to
reinforce the abstinence messages delivered in the classroom
and to provide youths with alternatives to high-risk behaviors.
Many states also support community-wide abstinence-only
initiatives, which attempt to alter youths' behaviors through
systemic changes in community norms, opportunities, and
support.
I cannot speak to the states' implementation of the Title V
Abstinence Education program. However, in the course of our
preliminary work to design the evaluation, we have observed a
wide range of initiatives. The following five programs
illustrate some of the efforts that we have observed:
A locally designed program in Florida has developed an
abstinence-only curriculum that is offered to youth in grades 6
through 12 as a yearlong elective class that meets five days
per week. Students receive an unequivocal message about the
value of abstinence, the power of building positive
relationships, and the strong benefits of marriage. The
classroom curriculum is reinforced and extended to encourage
parent support by regular home visits by social workers.
Another very intensive program, operating in New Jersey,
follows a leading national abstinence-education program model.
This school-based program offers a multifaceted youth
development curriculum with long-term adult involvement. It
provides girls with between 100 and 200 hours of interaction
with responsible adult mentors, most of whom are teachers, over
a minimum of three years. In addition, the program includes
health and fitness components and it offers a structured
curriculum covering topics such as friendship, decision-making,
love and dating, self-respect, and substance abuse.
In several Wisconsin middle schools, there is a program
that works with youth for two hours every day after school.
This program delivers strong abstinence messages every day
through a variety of means, including a formal curriculum that
emphasizes knowledge of anatomy, information about sexually
transmitted diseases and the values of marriage, and positive
skill-building activities such as job shadowing and exposure to
cultural events and positive social engagements. Youths
generally stay in the program throughout their middle school
years. Moreover, for many youths, program activities may extend
into the summer, when the abstinence curriculum and youth
development activities extend to all day, five days a week.
Virginia has a program for 8th and 10th graders that uses a
nationally marketed abstinence-education curriculum. The
program classes, which meet about 30 times a year, address
abstinence in the context of a curriculum strongly focused on
character development. The school-based abstinence education
efforts are bolstered by media campaigns, an information and
referral service, and community workshops. ``Booster''
activities to reinforce the abstinence messages and abstinence-
promoting and enabling skills are instituted for the 9th
graders.
And, Texas has a countywide initiative reaching students in
more than two dozen school districts with a national abstinence
education curriculum. This program has trained nearly 200
teachers to deliver the school-based curriculum; engages
physicians, counselors, and abstinence resource specialists for
``hot-lines'' to answer questions about sexually transmitted
diseases and other health risks associated with teen and out-
of-wedlock sex; produces and airs major media ``spots";
developed and administered tools to train medical professionals
in the promotion of abstinence; organizes community mentoring
programs for youth that promote abstinence; and has established
local monitoring and assessment efforts to guide community
planning.
In light of the breadth and depth of programs supported
through the Title V Abstinence Education program, the
evaluation will provide the much-needed evidence regarding the
potential of abstinence-only education strategies to promote
abstinence and other positive behavioral choices by our young
people. Moreover, the richness of program designs and the
variability in the implementation settings will facilitate
identifying model programs that are well suited to varying
local circumstances--for example, for communities willing to
institutionalize programs in their schools versus those where
it is most viable to situate programs in after-school or
community settings.
As others have documented in their testimony, the issues of
teenage sex and out of wedlock childbearing are extremely
important. We need to expand effective policies to reduce both.
For this reason, we have committed to the most rigorous
standards for conducting the Title V Abstinence Education
program evaluation. We will rely on experimental design studies
with large samples of youth to document the impacts of various
programmatic strategies on youths' behaviors, knowledge, and
attitudes. This rigorous impact analysis will be complemented
by extensive qualitative research that documents the nature of
the interventions; the circumstances and strategies for their
successful replication; and the mechanisms through which
programs can strengthen family values and responsible decision-
making among youth.
Chairman Johnson of Connecticut. Thank you very much, Ms.
Maynard.
Ms. Miller.
STATEMENT OF BRENDA RHODES MILLER, DEPUTY DIRECTOR, NATIONAL
CAMPAIGN TO PREVENT TEEN PREGNANCY
Ms. Miller. Good morning. Thank you for inviting me to
testify on the relationship between teen pregnancy prevention
and reducing nonmarital births. I am especially pleased by your
invitation because you are a member of our bipartisan House
advisory panel.
I am deputy director of the National Campaign to Prevent
Teen Pregnancy, which is a privately-funded, nonprofit,
nonpartisan organization here in Washington. It is clear from
all we have heard this morning that we must make it possible
for all young people to spend their teenage years on education,
growing up and enjoying their youth, not on rushing into adult
situations and assuming adult responsibilities.
Teen pregnancy affects not only the health and well-being
of babies born to teens but also the young parents themselves,
their families and the community at large. The relationship
between teen pregnancy and nonmarital births is stark. Nearly
three quarters of teen births are to unmarried teens, while as
recently as 1960 only 15 percent were. Teens account for
approximately 30 percent of all nonmarital births in the United
States but nearly half of all nonmarital first births.
I want to depart from my written testimony briefly to tell
you a little bit about two areas of the campaign's work that we
think are especially useful in the area of reducing teen
pregnancy in America. One area is our work including young
people in the prevention conversation and the other area is our
work with the entertainment media to change social norms.
First, let me tell you I stand in awe of the wisdom and the
energy of American teenagers. At the National Campaign to
Prevent Teen Pregnancy, we think it is enormously important for
us to listen to young people because teens are the least
represented in terms of having their voices heard in this area
of prevention. We know that many decisions are made that affect
young people's lives without any information from them on how
those decisions will play themselves out or what the decisions
will mean to them.
So last summer the campaign reached out to about 100
national and local organizations for help in building our youth
leadership team. The response was amazing. We got more than 150
nominations and we selected 13 boys and 13 girls, 15 to 18
years old, black, white, Latino, Asian and native American,
from the 20 States with high teen pregnancy rates or small
declines in the teen pregnancy numbers. These are thoughtful,
perceptive people who have strong opinions about teen pregnancy
prevention, opinions they back up with their life experiences.
The team includes young people who lead True Love Waits
projects as well as young people who are peer educators at
Planned Parenthood. We have Girl Scouts and 4-H members, former
gang bangers, members of the YWCA, boys and girls clubs
members, computer experts, dancers. We have a mother and a
father, both of whom are doing their best to be good parents,
while they work, go to school, and try to grow into productive
adults.
Their life experiences are powerful and telling. One young
girl explained what teen pregnancy meant to her community by
showing a home video she had made and explaining that there
used to be dozens of girls who could dance each year as Hopi
maidens, but now there are only a few. What she was telling us
was that teen pregnancy has made a big impact on her community
because there are no more maidens to dance.
A young man--a really good looking young man--told us that
he is often challenged to explain why a tall, good looking jock
like he is would wait until he got married to have sex. His
answer, which was based on his religious beliefs, was spiced
with a lot of humor. He says that he tells people, I am just
worth the wait.
We have learned from these kids that teenagers agree with
most adults, that teen pregnancy is not in anyone's best
interest, that they want to talk to adults about feelings,
about values, about love, sex and relationships. Though we have
also learned that a lot of teenagers have nowhere to turn for
information on these important subjects.
Much of what we have learned from the teenagers in the
youth leadership team are in these two publications that I have
provided to you. We have done these in both English and
Spanish. One of them is talking back, 10 things teens want
parents to know about teen pregnancy, and the other one is
thinking about the right now, what teens want other teens to
know about pregnancy prevention.
This leads me into the campaign's work with the
entertainment media. We are a small shop. We realized early in
the game that there was no way we could reach all the audiences
who needed to be reached with the message that teen pregnancy
is not OK. So, rather than throw up our hands in dismay, we
worked through our media task force to deliver key messages
about teen pregnancy prevention to our core audiences, which
includes boys and girls, parents, other adults, opinion
leaders. We brought in partners from radio, television,
magazines to help us deliver the prevention messages. We don't
beat the entertainment media over the head or blame them for
the problem. Rather, we enlist their support by providing them
with facts, information and brainstorming ways we can be
helpful to them in presenting the prevention messages. We work
in true partnership and focus on communicating prevention
messages rather than on just getting visibility for ourselves.
Last year, we had briefings for seven TV shows in
Hollywood, six daytime dramas in New York and the producers of
Black Entertainment Television teen's summit here in
Washington. As a result at least seven of these television
shows have incorporated campaign messages into story lines and
episodes, and I will say it fast, 7th Heaven, Dawson's Creek,
Party of Five, the Parenthood, Channel One, ER, and again,
Black Entertainment Television.
We believe our work with the national entertainment media
and our work with young people have a lot in common. The
campaign continues to learn from both groups about what is
important to them and what will move them to act in preventing
teen pregnancy in America.
Thank you very much.
[The prepared statement follows:]
Statement of Brenda Rhodes Miller, Deputy Director, National Campaign
to Prevent Teen Pregnancy
Good Morning. Thank you for inviting me to testify on the
relationship between teen pregnancy prevention and reducing
non-marital births. My name is Brenda Rhodes Miller and I am
Deputy Director of the National Campaign to Prevent Teen
Pregnancy and in the fall will lead a District of Columbia
Campaign to Prevent Teen Pregnancy.
I am especially pleased by the invitation because with the
support of several people here, the Campaign has established
two bipartisan advisory panels, one in the Senate co-chaired by
Joseph Lieberman (D-CT) and Olympia Snowe (R-ME) and one in the
House co-chaired by Nita Lowey (D-NY) and Mike Castle (R-DE).
The House Bipartisan panel has initiated a number of special
projects with the National Campaign. Indeed, the chair of the
subcommittee on human resources, Representative Nancy L.
Johnson, is an active member of the house advisory panel and I
thank her for including me in today's proceedings.
It is clear that we must make it possible for all young
people to spend their teenage years on education, growing up
and enjoying their youth, not on rushing into adult situations
and assuming adult responsibilities. Teen pregnancy affects not
only the health and well being of babies born to teens, but
also the young parents themselves, their families, and the
community at large. The relationship between teen pregnancy and
non-marital births is stark. Nearly three quarters of teen
births are to unmarried teens while as recently as 1960 only
15% were. Teens account for approximately 30% of all non-
marital births in the United States but nearly half of all non-
marital first births.
The Critical Importance of Reducing Teen Pregnancies to Child Health
and Well-Being
The National Campaign to Prevent Teen Pregnancy was
organized in 1996 by individuals who concluded, for a variety
of reasons, that reducing the nation's rate of teen pregnancy
was one of the most strategic and direct means available to
improve overall child well-being and to reduce persistent child
poverty. Although the Campaign's activities often bring it into
collaborative working relationships with those in the
reproductive health field, the Campaign should be seen, first
and foremost, as an intense effort to strengthen child health
and welfare.
Teen pregnancy and child-bearing go hand in hand with heavy
health risks for mother and child. Young adolescents
(particularly those under age 15) experience a maternal death
rate 2.5 times greater than that of mothers aged 20-24. Common
medical problems among adolescent mothers include poor weight
gain, pregnancy-induced hypertension, anemia, sexually
transmitted diseases (STDs), and cephalopelvic disproportion.
Later in life, adolescent mothers tend to be at greater risk
for obesity and hypertension than women who were not teenagers
when they had their first child.\1\ Moreover, the children of
teen mothers are at a significantly increased risk of at least
the following: low birth weight and prematurity, mental
retardation, insufficient health care, inadequate parenting,
abuse and neglect, poverty, growing up without a father, and
poor school performance.
---------------------------------------------------------------------------
\1\ Brown, Sarah and Leon Eisenberg (ed), The Best Intentions:
Unintended Pregnancy and the Well-Being of Children and Families.
Committee on Unintended Pregnancy. Institute of Medicine. Washington,
D.C.: The National Academy Press, 1995.
---------------------------------------------------------------------------
Low birth weight and related health problems: Infants born
to mothers 15 years-old or younger are more than twice as
likely to weigh less than 5.5 pounds at birth and three times
more likely to die in the first 28 days of life than infants
born to older mothers.\2\ Low birth weight raises the
probabilities of infant death, blindness, deafness, chronic
respiratory problems, mental retardation, mental illness, and
cerebral palsy. In addition, low birth weight doubles the
chances that a child will later be diagnosed as having
dyslexia, hyperactivity, or another disability.\3\
---------------------------------------------------------------------------
\2\ Ibid.
\3\ Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood
Foundation Special Report on the Costs of Adolescent Childbearing, New
York: Robin Hood Foundation, 1997; See also Wolfe, Barbara and Maria
Perozek, ``Teen Children's Health and Health Care Use,'' in Kids Having
Kids: Economic Costs and Social Consequences of Teen Pregnancy. Rebecca
A. Maynard (ed). Washington, D.C.: The Urban Institute Press, 1997.
---------------------------------------------------------------------------
Insufficient health care: Despite having more health
problems than the children of older mothers, the children of
teen mothers receive less medical care and treatment. In his or
her first 14 years, the average child of a teen mother visits a
physician and other medical providers an average of 3.8 times
per year, compared with 4.3 times for a child of older child
bearers.\4\ And when they do visit medical providers, more of
the expenses they incur are paid by others in society than is
the case among children of older mothers. One recent study
suggested that the medical expenses paid by society would be
reduced dramatically if teenage mothers were to wait until they
were older to have their first child.\5\
---------------------------------------------------------------------------
\4\ Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood
Foundation Special Report on the Costs of Adolescent Childbearing, New
York: Robin Hood Foundation, 1997; See also Wolfe, Barbara and Maria
Perozek, ``Teen Children's Health and Health Care Use,'' in Kids Having
Kids: Economic Costs and Social Consequences of Teen Pregnancy. Rebecca
A. Maynard (ed). Washington, D.C.: The Urban Institute Press, 1997.
\5\ Ibid.
---------------------------------------------------------------------------
Inadequate parenting: Children born to teen mothers are
also at higher risk because their mothers--and often their
fathers as well--are typically too young to master the
demanding job of being a parent. Still growing and developing
themselves, teen mothers are often unable to provide the kind
of environment that infants and very young children require for
optimal development. Recent research, for example, has
clarified the critical importance of sensitive parenting and
early cognitive stimulation for adequate brain development.\6\
---------------------------------------------------------------------------
\6\ Carnegie Task Force on Meeting the Needs of Children, Starting
Points: Meeting the Needs of Our Youngest Children, Carnegie
Corporation of New York, August, 1994.
---------------------------------------------------------------------------
Abuse and neglect: Children of adolescent parents also
suffer higher rates of abuse and neglect than would occur if
their mothers had delayed childbearing. For example, a recent
analysis found that there are 110 reported incidents of abuse
and neglect per 1,000 families headed by a young teen mother.
If these mothers had delayed childbearing until their early
twenties, this rate would be less than half this level--or 51
incidents per 1,000 families.\7\ Similarly, rates of foster
care placement are significantly higher for children whose
mothers are under 18. In fact, over half of foster care
placements of children with these young mothers could be
averted by delaying child-bearing, thereby saving taxpayers
nearly $1 billion annually in foster care costs alone.\8\
---------------------------------------------------------------------------
\7\ Maynard, Rebecca (ed), Kids Having Kids: A Robin Hood
Foundation Special Report on the Costs of Adolescent Childbearing, New
York: Robin Hood Foundation, 1997; See also Goerge, Robert M, and Bong
Joo Lee, ``Abuse and Neglect of the Children,'' in Kids Having Kids:
Economic Costs and Social Consequences of Teen Pregnancy. Rebecca A.
Maynard (ed). Washington, D.C.: The Urban Institute Press, 1997.
\8\ Ibid.
---------------------------------------------------------------------------
Poverty and single parenthood: Preventing teen pregnancy is
also important because of its persistent link to poverty and
other social ills. The growth in single parent families remains
the single most important reason for increased poverty among
children. Given that out-of-wedlock childbearing is currently
the driving force behind the growth of single parents and that
half of first out-of-wedlock births are to teens, reducing teen
pregnancy and child-bearing is an obvious place to anchor any
serious effort to reduce poverty in future generations. And
since more than three quarters of unwed teen mothers end up on
welfare, it is also a good way to reduce welfare dependency and
its costs to society.
School performance: Compared with children from the same
background who grow up with both biological parents, children
raised in single-parent households are more likely to drop out
of high school, less likely to attend college, and less likely
to graduate from college if they attend. Before leaving high
school, children from single-parent homes score lower on
standardized achievement tests, have lower grade point
averages, have more erratic attendance records, and have lower
college expectations. These children also show more behavioral
and emotional problems while growing up, as reported by parents
and teachers.\9\
---------------------------------------------------------------------------
\9\ Brown, Sarah and Leon Eisenberg (ed), The Best Intentions:
Unintended Pregnancy and the Well-Being of Children and Families.
Committee on Unintended Pregnancy. Institute of Medicine. Washington,
D.C.: The National Academy Press, 1995.
---------------------------------------------------------------------------
The bottom line: One of the reasons that this country
continues to struggle with seemingly intractable poverty and
social burdens is that, at present, over 40 percent of first
births in this country are to women with one or more of the
following attributes: being under 20, unmarried, and/or lacking
a high school diploma. If we can reduce this figure
substantially (as we would if teen pregnancy alone were
reduced--these three measures are highly interrelated), we can
anticipate significant overall improvement in a whole range of
problems that now burden us, from poor health to school failure
to poor job skills. We understand that poverty is a cause as
well as a consequence of teen pregnancy, and we try constantly
to help people understand the connection. But while we all wait
for an effective national assault on poverty, we urge attention
to a more focused and immediate goal: reducing teen pregnancy.
In essence, we're trying to get at one of the major sources
of our enduring social problems--children having children. As
such, we are working on a two generational agenda. And although
we understand that there is still some controversy (within the
research community) about how much a reduction in teen
childbearing would improve the lives of young women themselves,
there is no question about the benefits that children realize
when they have mothers--and, hopefully, fathers, too--who are
ready to assume the responsibilities that being a parent
entails. Although reducing teen pregnancy obviously would not
eliminate all our social ills, it would move us forward
significantly.
It's important to add, incidentally, that working to reduce
rates of teen pregnancy is not a quixotic quest. Lower rates of
teen pregnancy and child-bearing are reported in all of the
other industrialized countries to which the United States
typically compares itself, and the fact that U.S. rates have
fluctuated significantly over this century shows that they are
not set in stone. Moreover, declines since 1991 in both the
teen birth and teen pregnancy rates demonstrate that U.S. rates
can decrease steadily; although these rates are still very high
(even above those in the 1980s), we should all be encouraged by
the recent good news and motivated to take the additional steps
necessary to sustain the downward trend.
The Campaign's Strategy
The Campaign's program and strategy over the next three
years are based on two key goals: (1) strengthening social
norms through our own actions and those of others; and (2)
creating a national movement through better coordinated and
supported state and local efforts. In both of these areas, the
Campaign serves as a catalytic group emphasizing highly
leveraged activities that complement and extend the
programmatic solutions to teen pregnancy emphasized by other
groups.
Strategy #1.--Strengthening Social Norms
The Campaign has become convinced that one of the main
reasons that we have high rates of teen pregnancy in the United
States is that the nation lacks clearly articulated social
norms and expectations that would lead to reduced rates of teen
pregnancy. In particular, influential groups and individuals
rarely speak clearly and forcefully against teenaged pregnancy,
or about expected standards of adolescent sexual behavior. Even
though polling data and survey research reveal an impressive
national consensus in both of these areas, this consensus is
often obscure or, at worst, invisible. Accordingly, the
Campaign is giving major strategic priority to articulating and
strengthening the underlying national consensus regarding both
these issues.
With regard to the first norm, although few are in favor of
teen pregnancy and child bearing, the adults in this country
seem oddly reluctant to state crisply and often that
adolescence is for education and growing up, not pregnancy and
parenthood, that children need adult parents, and that
pregnancy and parenthood at a young age is in no one's best
interest. Adults seem to hedge about this, fearful of hurting
feelings, of devaluing those who have born children in their
teens, of making a values-based statement.
In the Campaign's view, this reluctance to speak clearly
against teen pregnancy contributes directly to the high levels
of non-marital teen pregnancy that the nation is currently
experiencing. In the absence of well-articulated standards,
social norms and expectations, it is all too easy for young
people to fail to do one of the only two things that will avoid
pregnancy--abstaining or using contraception extremely
carefully. Both take motivation and work, and both rest on some
sort of basic conviction, belief or value. In a culture that
fails to speak clearly about whether teen pregnancy is or isn't
okay, how can we be surprised if so many pregnancies occur?
It is therefore critical that there be more explicit and
powerful articulation of the basic concept that non-marital
teen pregnancy and childbearing are in no one's best interests.
The clear, unambiguous message must be that at this time, in
this country, in this economy with its ever-rising requirements
for an educated work force, the adolescent years must be used
for education, skill-building and maturation. As alluded to
earlier, recent research on early childhood development in the
first weeks and months of life shows ever more conclusively the
critical need that infants have for adult parents able to
provide irreplaceable stimulation, stability and care early in
life. All children need parents who are ready to take on the
most important responsibility that any adult undertakes.
Pretending otherwise--or worse, not speaking directly about all
this--serves no good end.
New efforts must also be made to give voice to a second
strong national consensus that is not well articulated,
especially at the national level: teenagers should abstain from
sex during the school years; those who become sexually active,
however, should have access to contraception. In a 1997 poll
conducted by the Campaign, 95% of both adults and teens agreed
that society should give kids a strong message that they should
abstain from sex at least until they are out of high school.
There is no ambiguity about this shared national value. As is
well known, however, not all teens are going to achieve this
standard and therefore a majority of Americans also support the
notion that sexually active teenagers should have ready access
to contraception. But the acceptance of contraception seems
grounded in a clear preference for abstinence as the desired
standard of behavior.
At the Campaign, we approach this task at two levels: what
the Campaign itself can accomplish with our own resources to
strengthen these two points of consensus, and what the Campaign
can encourage other groups and social sectors to undertake as a
result of our leadership.
What the Campaign itself can do: The Campaign increasingly
threads these two social norms throughout all our work. We
include them in our publications, advocacy, conferences, and
seminars. And in particular, we express them in our frequent
contacts with the press and in our work with media leaders. We
do not shy away from taking clear positions on both of these
issues, and we seek opportunities to state them crisply and
publicly. We believe that our willingness to address social
norms and to discuss values is one of the Campaign's unique
characteristics, absent from most other groups working on this
and related topics. Were we to ignore the values dimension of
the problem, we believe our strategy would be missing one of
the core challenges in reducing teen pregnancy.
Is the Campaign's focus on values and social norms useful?
We can only report that we have been stunned by the power of
our position. In speech after speech, in media briefing after
media briefing, in community after community, we hear
constantly that our taking an unambiguous stand in these two
areas is not only powerful, but also unusual. One woman in
Atlanta said to the Campaign's director recently, ``I've worked
in this field now for over ten years, and I don't ever recall
anyone or any group offering such straight talk [sic]. Don't
you ever get in trouble?'' Well, so far, no. We are amazed that
taking a clear stand can be valuable in and of itself,
particularly if the position resonates with the majority of
Americans, as we believe ours does.
What other groups can do: As intent as the Campaign is on
giving new voice to these basic ideas and values ourselves, we
remain a very modest organization with a small staff and
budget. Obviously, the challenge of influencing and clarifying
social norms is enormous and will require the efforts of many
groups. Accordingly, the Campaign invests heavily in urging
other groups and social sectors to act. That is, the Campaign
has very consciously adopted a ``high-leverage'' approach to
extend its influence and reach far more groups and individuals
than it ever could reach on its own.
At present, we are working hard to enlist the interest and
help of the entertainment media and we are also reaching out to
parents and other adults deeply involved in the lives of young
people. We are especially proud of our work with young people
themselves and faith communities.
(a) The entertainment media: One of the most efficient ways
to communicate with the nation about social norms or any other
topic is through the media, especially the entertainment media,
which is a pervasive force in American life and a major arbiter
of culture. The ability of the media to convey information,
shape values, and influence attitudes is well known.
Recognizing how powerful this sector can be, especially if it
were to be enlisted in reducing teen pregnancy, the Campaign is
placing its highest priority on work with the entertainment
media, both print and broadcast.
With the help and leadership of our Media Task Force, we
are now working productively with a wide variety of media
groups. Rather than taking the traditional public service
announcement (PSA) route, which can have limited reach and
unpredictable viewership, we instead are working in partnership
with entertainment media leaders, offering each a menu of ideas
and messages that we ask them to weave into their story lines
over time. Many young people pay close attention to what their
favorite characters on television say and do, and many parents
feel that the media can and should echo the prevention messages
they are trying to teach at home. By working with decision-
makers in many parts of the entertainment media industry, the
Campaign is reaching a wide variety of audiences with important
prevention messages delivered in ways that are appealing and
memorable to them.
(b) Parents: In spring of 1998, the Campaign emphasized
another approach to reducing teen pregnancy that is rarely
spotlighted: encouraging parents and adults generally to take a
more active role in supervising and communicating with their
children about a wide range of issues related to sex, love and
relationships. We published a review of 20 years of research
about the powerful role that families play in reducing sexual
risk-taking,\10\ and translated these findings into Ten Tips
for Parents to Help Their Children Avoid Teen Pregnancy.
---------------------------------------------------------------------------
\10\ Miller, Brent. (1998). Families Matter: A Research Synthesis
of Family Influences on Adolescent Pregnancy. Washington, DC: The
National Campaign to Prevent Teen Pregnancy.
---------------------------------------------------------------------------
(c) Youth themselves: In January 1999, 26 outstanding young
people, (13 boys and 13 girls), from all over America joined
the National Campaign to form the Youth Leadership Team.
Nominated by organizations across the country, the Youth
Leadership Team advises the Campaign and gives voice to the
unique perspectives and opinions of teens. They represent 20
states and organizations ranging from Best Friends to 4-H to
Planned Parenthood to the YWCA to the Girl Scouts to the
Mexican American Community Services Agency to the United Way.
The Youth Leadership Team meets twice annually and has
contributed to recent Campaign publications including Talking
Back: Ten Things Teens Want Parents to Know About Teen
Pregnancy and Thinking About the Right-Now: What Teens Want
Other Teens to Know About Preventing Pregnancy.
(d) Faith Communities: Given the pervasiveness of religious
organizations and the large number of Americans affiliated with
an organized religion, the deep religiosity of this country,
the important role that values and moral choices make in sexual
behavior, and the growing concern among religious leaders about
the state of the American family, the Campaign has reached out
through Nine Tips to Help Faith Leaders and Their Communities
Address Teen Pregnancy, (written by the Campaign's Task Force
on Religion and Public Values) and through a series of regional
meetings for faith leaders. The religious community is large,
powerful, and one of the most influential centers of leadership
in the country. Our goal in working with faith community
leaders will be to enlist their interest in preventing teen
pregnancy, to learn how they are already supporting families
and teenagers themselves, and to explore ways that the Campaign
can support their efforts.
Strategy #2.--Creating a National Movement Through Strengthened
and Better Coordinated State and Local Efforts
The Campaign matches its ``top down,'' high-leverage
efforts just described with a strong focus on creating a
``bottom up'' national movement. We do so by providing state
and local programs, coalitions, and leaders with a wide variety
of materials, ideas, and hands-on assistance and encouragement.
Linking state and local efforts: Over the last three years
the Campaign has learned that although many states and
communities have various coalitions and programs to reduce teen
pregnancy, they are generally quite fragile and disconnected
from one another. They are rarely based on strong theory or
solid research, and there are few mechanisms in place for
people to learn what others are doing in their own state and
around the country. In response, the Campaign is trying to
bolster state and local efforts in a variety of ways: through
technical assistance, by producing and disseminating research-
based publications, and by holding conferences and meetings for
individuals at the state level. We have also developed an
interactive bulletin board on our web site that allows state
and local practitioners to communicate directly with each other
and the Campaign about new strategies, points of interest, and
upcoming events. (The idea for this originated at the
Campaign's state-based media conference in June 1997, where
participants from 41 states lamented the lack of connection
among state practitioners working in teen pregnancy
prevention.) In these disparate ways, our objective is to
foster a national movement from a set of often disconnected
parts.
The Campaign also continues to visit states and local
communities (more than 40 states at last count) to learn more
about what they are doing and what problems they have
encountered, as well as to communicate new ideas about
preventing teen pregnancy. At these ``site visits,'' the
Campaign meets with local leaders, talks with teenagers, learns
more about coalition-building and local programs from the
people ``on the ground'' who are doing the work. In addition,
the Campaign shares ideas gleaned from visits and consultations
all over the country as a way to connect teen pregnancy
prevention efforts nationwide.
While the states and local communities first and foremost
want more money to fund their work, their second major request
is for technical assistance with their specific challenges they
face in planning and implementing prevention initiatives. In
response, the Campaign provides ongoing help to communities in
working through problems and identifying resources of all
kinds. Most recently, Campaign staff provided individuals
working in states and communities with a list of suggested
activities for Teen Pregnancy Prevention Month in May. As a
result, a number of states organized linked activities and
events.
Tool kit: A major component of our work with states and
communities involves the release of a practical, ``user-
friendly'' tool kit for states and communities searching for
ways to reduce teen pregnancy in their areas. Developed in
close consultation with our Task Force on State and Local
Action, this tool kit provides concise tips for communities on
how to develop teen pregnancy prevention programs and
partnerships. It includes information on what is needed to
develop a sustainable program and what its activities might
usefully include. Information targets, for example, how to
handle the conflict that work on this problem often generates,
how to involve youth in community programs and planning, and
how to conduct a review of the evidence on promising programs.
Conflict reduction: In our work with states and
communities, we give special emphasis to conflict reduction,
quite simply because so many local and state leaders have
reported that controversy and divisive publicity too often
greet bold actions to reduce teen pregnancy--and that the
controversy and hostility can spring from right or left,
depending on the solution being advocated. We have been so
struck by the tensions in this area that we have developed a
saying in the office that captures the problem: while the
adults are arguing, the kids are getting pregnant. In our view,
unless communities can find new ways of doing business in this
field--ones that are less prone to eruptions, blow-ups, and
angry editorials in the newspaper--we will continue to be
limited in our ability to decrease teen pregnancy.
Under the guidance of the Campaign's Task Force on Religion
and Public Values, we have developed an approach to community
conflict that is designed to reduce tensions and allow
progress. This community process (called ``structured community
dialogues,'' or SCDs) was recently piloted in California. With
Campaign leadership and guidance, a group of community leaders
in San Bernardino active in teen pregnancy prevention engaged
in a two-day SCD that increased mutual tolerance and helped the
participants to build areas of common ground and action. The
Campaign's publication, While the Adults are Arguing: The Teens
Are Getting Pregnant was produced following the San Bernardino
meeting. Subsequent to the San Bernardino pilot, a similar
meeting took place in Glendale, Arizona with tremendous
community support. A goal is to use this same approach in three
or four other communities in order to demonstrate the value of
this model for breaking deadlocks at the community level.
Conclusion
We're often asked to summarize briefly the Campaign's
overall approach. Here's the briefest summary statement we've
yet devised:
The United States has the highest rate of teen pregnancy in
the industrialized world. Two-fifths of our teenaged girls
become pregnant before their twentieth birthday. Almost half of
first births today are to mothers who are either teens,
unmarried, or lacking a high school degree. This does not auger
well for the future of our economy or our society.
This dismal situation is unlikely to improve significantly
without clearly articulated social norms and expectations that
discourage teenage pregnancy. Young people today are heavily
influenced by the media and by peer group pressures that
romanticize sex and child-bearing, and they are spending less
time with parents or other responsible adults who could counter
such influences.
There is a consensus in this country that non-marital teen
pregnancy is not acceptable or ``okay,'' and that teens should
delay sex and pregnancy at least through high school, although
the public wants contraception to be available to those who
need it. The Campaign's goal is to strengthen and clearly
articulate these points of consensus through our own efforts
and with the help of such other powerful sectors as the media,
faith leaders and youth themselves. We also seek to support and
honor other organizations whose programmatic efforts in this
area are most effective, and to build a national movement to
reduce teen pregnancy out of a myriad of smaller efforts at the
state and local levels. In all these activities, we seek to
decrease unproductive conflict and help all to find areas of
common ground and common action.
Thank you.
Chairman Johnson of Connecticut. Thank you, Ms. Miller. I
appreciate that.
Mr. Tetelman.
STATEMENT OF EDWARD TETELMAN, ASSISTANT COMMISSIONER, NEW
JERSEY DEPARTMENT OF HUMAN SERVICES
Mr. Tetelman. Thank you for inviting me. I am Ed Tetelman.
I am the assistant commissioner for the Department of Human
Services, and I am pleased to discuss this important topic with
you.
In New Jersey, we have been fortunate to have clear
leadership from our governor Christie Whitman on the problems
related to teen pregnancy and nonmarital births. Most New
Jersey teens who give birth are unmarried or in marriages that
don't last very long. New Jersey's teen pregnancy rate is 35
per 1,000 births as compared to the national average of about
54 per 1,000.
In New Jersey, our efforts to prevent teen pregnancy range
from the creation of an 800 number that teens can call to find
out about family planning services to developing a pool of
mentors who impart information and a message that sometimes
unfortunately just doesn't come from parents.
Let me tell you a little bit about the specifics of these
programs. Last year, Governor Whitman directed $1 million, TANF
dollars, to an adolescent pregnancy prevention initiative. That
initiative includes a strong mentoring effort. I want to thank
the committee for granting the States the flexibility with TANF
funds to making this program possible. If we didn't have that
flexibility, we wouldn't be able to do this.
In our first mentoring program we have adults working with
teens at risk of becoming pregnant. These adults provide
counseling and family planning information, but probably the
most important thing they do is to--and the hardest to measure
is that they help to build self-esteem. They help teens learn
how to make decisions for themselves, and they encourage a
young woman to look beyond today. A caring adult can have a
profound influence on a teenage girl as she struggles to define
her own self-image.
Our second mentoring program uses teen mentors, and they
provide similar information about family planning and related
health issues. Peer pressure among teens is especially intense.
Its influence often results in teens making poor or self-
destructive decisions based on bad or no advice. We realize
that the carrier of the message can be as important as the
message itself.
Another initiative is the governor's allocation of $100,000
to create an 800 number hotline that provides counseling
referrals to teens who are weighing practical decisions around
sex and related health issues. Also, our counselors advise that
abstinence is the only guaranteed way of preventing pregnancy
or avoiding a sexually transmitted disease.
To publicize these prevention efforts, last year we
undertook a public relations campaign. As a result, the hotline
calls increased by 600 percent. One of the reasons New Jersey
was able to develop these programs so quickly is that we had
some solid experience to draw on from our school-based youth
services program. This program offers comprehensive service on
a one stop shopping basis in or near schools. The core services
of employment, mental health and family counseling, healthcare,
counseling and family planning, as well as recreation and
information and referral.
The staff develop relationships based on trust, and from
that relationship they are able to provide teens with the
ability to express their feelings so that if they want to say
no to sex they can. However, if they are engaged in sex, they
receive the information they need to protect themselves.
Our school-based program has shown dramatic reductions in
adolescent pregnancies and repeat pregnancies. At one of our
school-based sites there had been on the average about 20 teen
births a year. After our program began providing counseling and
family planning service that number dropped to three
pregnancies or less a year at the high school, remaining so for
over 8 years. The keys to success are connections and
collaborations between educators, counselors, healthcare
providers with teens at the ground level.
As part of our most recent effort to enhance prevention
efforts, Governor Whitman held regional forums on the
prevention of adolescent pregnancies, including teens.
Additionally, the Governor has established an Advisory Council
on Adolescent Pregnancy that represents varied opinions in the
field.
We have learned a number of lessons from our teen pregnancy
programs. First, school-based programs work, and second, that
there was a correlation between the numbers of births to a teen
and her age. We concluded that as we develop programs we must
consider the different dynamics that lead to pregnancies in
girls under 14 years of age and those between 17--15 and 17 and
those between 18 and 19 years old, where in New Jersey it is
the bulk of the young women getting pregnant, about 6,000.
We noted that in all successful programs that collaboration
and coordination was the key. We also established to carry this
out an interdepartmental work group on adolescent pregnancy.
This group developed county teen pregnancy initiatives,
coordination that looked at existing programs to get the
message through our existing programs, as Dr. Nathan says,
Medicaid, school to work and those types of programs, and a
public relation campaign that includes public service
announcements for movie theaters, as well as TV and radios. The
30-second spot will be viewed before PG and R movies and will
spread our prevention message to a teenage audience.
Additionally, there are wallet-sized cards with pertinent
information and posters to promote the hotline.
I would like to close with just a brief discussion on the
role of TANF dollars in the prevention of pregnancy. No. 1,
TANF dollars pay for our mentoring programs. TANF dollars also
support our child care efforts in 11 highly successful
adolescent parent programs that are located in schools
throughout the State with high pregnancy rates. These programs
have almost no repeat pregnancies and close to 100 percent
graduation rates. By the way, most of those young women go on
to jobs and college. The programs assist teen moms to stay in
school as required also by the TANF regulations themselves.
TANF dollars have also been used to leverage other dollars
from other sources, from foundations and Children's Trust Fund.
And in closing, New Jersey is committed to reducing teen
pregnancy. The welfare reform message of personal
responsibility, along with the flexible use of Federal dollars,
has allowed us to take important steps to address this issue.
We all recognize this is not just a welfare issue and that we
must continue to engage parents, government, business,
educators, the community and faith-based organizations, as well
as teens. Obviously, we still have a lot of work to do to
reduce teen pregnancy, and New Jersey is committed to the goal.
Finally, your focus on teen pregnancy prevention and
nonmarital births today highlights your commitment to breaking
the cycle of welfare dependency and ultimately giving a young
person an opportunity to make choices in their best interest.
Thank you very much.
[The prepared statement follows:]
Statement of Edward Tetelman, Assistant Commissioner, New Jersey,
Department of Human Services
Thank you for inviting me to speak with you today. I am Ed
Tetelman, Assistant Commissioner of the New Jersey Department
of Human Services. I am pleased to be with you as we discuss
this important topic.
In New Jersey, we have been fortunate to have clear
leadership from our Governor, Christie Whitman, on the problems
related to teen pregnancy and non-marital births.
Most New Jersey teens who give birth are unmarried, or are
in marriages that, in many instances, won't last.
New Jersey's teen pregnancy rate is 35 per 1,000, as
compared with the national average of 54 per 1,000.
In New Jersey, our efforts to prevent teen pregnancy have
ranged from the creation of an 800 number that teens can call
to find out about family planning services to developing a pool
of mentors who impart information and a message that sometimes,
unfortunatey, just doesn't come from a parent.
Let me tell you a little bit about the specifics of our
programs.
Last year, Governor Whitman directed $1 million in TANF
dollars to an Adolescent Pregnancy Prevention Initiative. I
want to thank the committee for granting states flexibility
with tanf funds making this program possible.
The initiative includes a strong mentoring approach. First,
we have adults working with teens at risk of becoming pregnant.
These adults provide counseling and family planning
information. But probably the most important thing they do is
the hardest to measure. They help build self-esteem, and help
teens learn how to make decisions for themselves. They
encourage the young woman to look beyond today.
A caring adult can have a profound influence on a teenage
girl as she struggles to define her own self image.
Our second mentoring program is similar with one key
difference: the mentors are teenagers themselves. They provide
similar information about family planning and related health
issues.
Peer pressure among teens is especially intense. Its
influence often results in teens making poor or self
destructive decisions based on bad or no information.
We realized that the carrier of the message can be as
important as the message itself.
Another initiative is the governor's allocation of $100,000
to create a toll-free hotline that provides counseling and
referrals to teens who are weighing practical decisions about
sex and related health issues.
Our counselors advise that aBstinence is the only
guaranteed way of preventing pregnancy or of avoiding a
sexually transmitted disease.
To publicize our prevention efforts, Last year we undertook
a public relations campaign. As a result, calls to the hotline
have continued to climb as this campaign has gained momentum.
We have seen a greater than 600 percent increase in calls since
we began the campaign.
One of the reasons New Jersey was able to develop these
programs so quickly is that we had some solid experience to
draw on with our school-based youth services program.
This program offers comprehensive services on a one-stop
shopping basis in or near schools. The core services include
employment services, mental health, family counseling, and
health services, including family planning and counseling.
The staff develop relationships based on trust. From that
relationship, they are able to provide teens with the ability
to express their feelings so that if they want to say no to
sex, they can.
However, if they are engaged in sex, they receive the
information they need to protect themselves.
Our school-based program has shown dramatic reductions in
adolescent pregnancies and repeat pregnancies.
At one of our school based sites, there was on average
about 20 teen births each year. After our program began
providing counseling and family planning services, that number
dropped to three pregancies or less each year at the high
school--
remaining so for over eight years. the keys to success are the
collaborations that are developed between educators, counselors
and health providers with the teens from the outset.
As part of our most recent effort to enhance prevention
efforts, Governor Whitman held Regional forums on the
prevention of adolescent pregnancy.
Additionally, the governor has established an Advisory
Council on Adolescent Pregnancy that represents the varied
opinions of those in the field.
We have learned a number of lessons from our teen pregnancy
programs.
First, there have been extraordinary reductions in births
to teens in some of our School-Based Youth Service Program
sites; and second, there is a corrolation between the numbers
of births to a teen and her age.
We concluded that as we develop programs, we must consider
the different dynamics that lead to pregnancies in girls under
14 years of age (fewer than 350 a year), those 15 to 17 years
(3,500) and those 18 and 19 years old (6,000).
We noted that in all successful programs, the local
educators, health providers, and mental health and employment
counselors were working in a coordinated fashion and made great
efforts to create a seamless connection to provide necessary
services.
Accordingly, collaboration and coordination became key to
New Jersey's efforts.
We established an inter-departmental WorkGroup on
Adolescent Pregnancy Prevention. Senior representatives from
the New Jersey Departments of Education, Health and Senior
Services, Labor, Community Affairs, Child Abuse Prevention and
Juvenile Justice participated. Following are some of the
activities this group helped to organize:
County-based teen pregnancy prevention efforts.
These programs were developed locally by educators, service
providers, business representatives, government officials, and
most importantly, teens.
Coordination with other state programs, such as
paternity support, Adolescent Health, the Abstinence grants of
the NJ Dept. of Health and Senior Services, Medicaid, school-
to-work, housing, domestic violence, employment and training,
and youth and family services.
A public relations campaign that includes Public
service announcements for movie theaters as well as TV and
radio. The 30-second spot will be viewed before PG and R movies
and will spread our prevention message to a teenage audience.
I'd like to briefly discuss the role of TANF dollars in the
prevention of pregnancy.
The 22 mentoring programs I spoke of earlier are supported
with TANF dollars.
TANF dollars support childcare for 11 highly successful
adolescent parent programs that are located in schools
throughout the state with high pregnancy rates. These programs
have almost no repeat pregnancies and close to 100% graduation
rates. they assist teen moms in staying in school as required
by the TANF regulations.
TANF dollars have also been used to leverage dollars from
other sources. For example, children's trust fund and
foundation dollars pay for special programs for fathers and are
used to expand mentoring to a larger number of youth.
In closing, New Jersey is commited to reducing teen
pregnancy. The Welfare reform message of personal
responsibility along with the flexible use of federal dollars
has allowed us to take important steps to address this issue.
We all recognize that this is not just a welfare issue and that
we must continue to engage parents, government, business,
educators, commumity and faith-based organizations, and, of
course, teens. We still have a lot of work to do to continue to
reduce teen pregnancy, and we remain committed to that goal.
We applaud the committee for examining the issue of non-
marital births and look forward to working with you in the
future.
I would be happy to respond to any questions.
Chairman Johnson of Connecticut. Thank you very much.
Mr. Sciamanna.
STATEMENT OF JOHN SCIAMANNA, SENIOR POLICY ASSOCIATE, AMERICAN
PUBLIC HUMAN SERVICES ASSOCIATION
Mr. Sciamanna. Thank you, Madam Chair. My name is John
Sciamanna. I am a senior policy associate at the American
Public Human Service Association. Thank you for the opportunity
to share preliminary results of our survey on State efforts to
reduce nonmarital births and in particular to prevent teenage
pregnancy. I will summarize my testimony.
The reduction of teenage pregnancy in nonmarital births are
of key concern to State health and human service directors.
They know that the prevention of teenage births will reduce
future dependence on public assistance and poverty. The
Personal Responsibility and Work Opportunity Reconciliation Act
placed an emphasis on reducing nonmarital births. In the 3
years since its passage APHSA together with the Population
Resource Center has sponsored national meetings to examine
State strategies and programs in out-of-wedlock births. The
survey I will summarize for you today is another in our efforts
to highlight the importance of this issue to our organization
and to our members.
Since August 1996 the goal of State TANF programs has been
on moving families from welfare to work. States are also
focusing attention on this issue by expanding past State health
department efforts in initiating new TANF funded programs.
Efforts to reduce teen pregnancy is not limited to the TANF
arena. It is a broader issue that spans income groups and must
be addressed by a comprehensive approach involving State and
local parties, programs and community-based organizations. It
is key to the success of welfare reform that we address both
the needs of adults on TANF as well as the needs of their
children, and preventing an unintended pregnancy is part of
that strategy.
I would like to share with the committee some of the
initial information on State efforts that we have received so
far. Thirty-six States indicated to us that they are funding
teen pregnancy or out-of-wedlock birth prevention programs with
either Federal TANF funds or State maintenance of effort TANF
funds. Nine of these thirty-six are using TANF funds
specifically for abstinence education efforts. Title V funds,
as we talked about, are available to all States for programs
that emphasize abstinence, and these nine States are
supplementing that effort.
State policies incorporate a range of strategies. At least
16 of the 36 States are running statewide programs, while 14
are funding local initiatives and the rest of the States are
combining both approaches. Eleven States are using funds to
evaluate abstinence education or teen pregnancy prevention or
out-of-wedlock birth programs. We are seeing more investment
here since experts from the field as we have heard today have
indicated that past programs have not always been subject to
rigorous evaluation.
Nine States are using media campaigns as part of their teen
pregnancy prevention strategy, while an additional twenty used
media campaigns as part of their abstinence education strategy.
In fact, last summer during a Capitol Hill briefing on TANF, we
featured a media spot that was developed for the State of
Mississippi by a media consultant who worked with teenagers in
shaping the message of that entire media campaign.
Ten States are providing pregnancy prevention programs with
technical assistance, including curriculum development, an
additional fourteen specifically targeting this assistance to
abstinence education efforts. I would like to offer a few
specific examples of what we have heard so far.
Your home State, Connecticut, is using a combination of
both State and TANF funds to support 18 pregnancy prevention
models based on Dr. Michael Carrera's model. He serves, in
fact, as a consultant and he has a very interesting and dynamic
approach that follows kids with a range of supports and skill
building services.
Maryland is targeting the prevention of second births to
teen parents. The State is investing $1 million in the home
visiting program and a father involvement program. The programs
target teenagers who are expecting and are receiving TANF or
come from families that have received TANF. The fatherhood
program seeks to improve the long term involvement of both
parents. Maryland is also using its abstinence funds in a media
campaign as well as investing in after school youth development
programs.
Louisiana has designed a pilot project that targets the New
Orleans area. Ten contracts have been issued to community-based
groups. Components of these programs include youth development,
comprehensive health and family life education, parental
involvement, mental health services and counseling and male
involvement. The target populations there include 11- to 19-
year-olds, teen parents and parents of teenagers.
Pennsylvania is using its abstinence education dollars to
develop a 5-year initiative. The 5-year project, called
abstinence education and related services, is funding 28
projects that cover 35 counties. The abstinence program
includes mentoring, adult supervision and counseling. Training
programs in abstinence education for teens, parents, peers and
health professionals is also provided.
Michigan is funding 18 community coalitions to provide an
abstinence message that is geared specifically to the local
needs of that particular community. The program places an
emphasis on 9- to 14-year olds.
Florida is a State that has included an evaluation
component. Florida is evaluating five pilot projects that use
different pregnancy prevention strategies. These projects
include family life and sexuality education, medical and mental
health services, tutoring, job and career service activities,
mentoring and community service activities. Parents are
encouraged to participate with their children. The programs
serves approximately 1,600 at risk middle school teens. At the
same time, Florida has funded 17 statewide abstinence education
grants to a variety of community-based organizations.
These are a few of the examples of current State approaches
in strategies. APHSA will be happy to provide the committee
with our full report to be issued in the coming weeks. We
expect to see expanded investment of TANF funds, greater
coordination between departments and partnerships.
Thank you for the opportunity to testify today.
[The prepared statement follows:]
Statement of John Sciamanna, Senior Policy Associate, American Public
Human Services Association
Madam Chairman, Congressman Cardin, members of the
Committee, goodmorning. My name is John Sciamanna; I am a
Senior Policy Associate atthe American Public Human Services
Association. I am here today to sharepreliminary results of our
survey of state efforts aimed at reducing non-marital births
and in particular, to prevent teenage pregnancy.
As you know, the reduction of teenage non-marital births
are a key concern to state health and human service directors
throughout the country. They know that prevention of teenage
births will significantly reduce future dependence on public
assistance and poverty. The Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 placed a special
emphasis on reducing non-marital births. Since the enactment of
the law, APHSA has placed an emphasis on this issue by
convening sessions to examine state strategies, promising
programs and by encouraging states to use their TANF block
grant funds for this purpose.
In March 1997, October 1998 and March 1999, together with
the Population Resource Center, APHSA sponsored national
meetings in Washington and the Southern part of the country to
examine local programs. We invited local pregnancy prevention
program managers to Washington to explain their approaches in
their various cities.
In the past few years, the goal of state TANF programs has
been on moving families from welfare to work, however, states
are also focusing more attention on this issue by expanding
past health department efforts and initiating new TANF-funded
programs. It should be emphasized that reducing teen pregnancy
is not confined just to the TANF arena but it is a broader
issue that spans income groups and must be addressed by a
comprehensive approach involving a cross-section of state and
local departments, programs and communities-based
organizations.
APHSA believes it is fundamental to the success of welfare
reform that we address not just the needs of adults on TANF but
we must also build a strategy that addresses the needs of their
children and preventing an unintended pregnancy is part of that
strategy.
APHSA began a survey of states on their work in this area
and at this point we have received responses from forty-four
states and three territories. I would like to share with the
Committee the preliminary findings of a soon-to-be-published
report that highlights the wide range of state initiatives
underway.
Thirty-six are funding teen pregnancy or out-of-wedlock
birth prevention programs with either federal TANF funds or
state Maintenance-of-Effort funds. Nine of these thirty-six
states are using TANF funds specifically for ``abstinence-
only'' education efforts while thirty-six states are funding
their 'abstinence-only'' programs with Title V funds.
State policies incorporate a range of strategies including
media campaigns, case management services to prevent second
births, teen support and education programs, after-school
programs that include abstinence education, youth conferences,
family life and sexuality education, tutoring, job and career
activities, medical and mental health services and mentoring
combined with community services activities to mention a few of
the policies.
Our survey information indicates that at least sixteen
states of the thirty-six states are running statewide programs
while fourteen are funding local initiatives and the rest are
using both approaches.
Eleven states told us that they were using funds to develop
and implement evaluation methods for statewide and local
abstinence education or teen-pregnancy prevention or out-of-
wedlock birth programs. We are seeing a greater investment in
evaluation of these programs since many experts from the field
have indicated that past programs and approaches have not
always been subject to such research.
Nine states reported using media campaigns as part of their
teen pregnancy prevention strategy while an additional 20 use
media campaigns as part of their abstinence education strategy.
I would add that last summer, during a Capitol Hill briefing on
TANF, we featured some of the media spots developed for the
state of Mississippi by a media consultant who worked with
teenagers in shaping the message.
Ten states are providing local pregnancy-prevention
programs with technical assistance including curriculum
development. An additional fourteen states are specifically
targeting this assistance to abstinence education efforts.
In an effort to coordinate these policies some states are
establishing councils that will bring all parties together in a
planning process. At least two governors have appointed
councils and another state has a twenty-five-member committee
created by the state legislature.
I would like to take this opportunity to focus on a few
examples of state efforts:
Georgia has 28 programs funded with $3.9 million of TANF
funds, that are aimed at reducing risk behavior and poor health
outcomes. Included in the Georgia strategy are male involvement
programs that promote responsible behavior, delayed fatherhood
and abstinence. These programs encourage community involvement
and also target parental involvement.
Maryland is targeting the prevention of second births to
teenage parents. The state is investing $1 million in a home
visiting program and father-involvement program. The programs
targets teenagers who are expecting and are either receiving
TANF or come from families that have. The fatherhood component
is an effort to improve the long term involvement of both
parents. The Maryland is also using its abstinence funds in a
media campaign as well as investing in after-school youth
development programs.
The state of Illinois has invested over $9 million in TANF
funds over two years in a program called ``REACH''--
Responsibility, Education, Achievement, Caring and Hope. This
effort targets 10 through 17 year-olds by creating structured
programs for out-of-school time. Local agencies are contracted
to provide services in communities that have a high
concentration of TANF families. Separately, the state has
contracted with 31 agencies in selected areas to focus on
abstinence-only education.
Louisiana has designed a pilot project that targets the New
Orleans area that has the highest teen-birth rate in the state.
Ten contracts have been issued to community-based groups. Some
of the components include youth development, comprehensive
health and family life education, parental involvement, mental
health services and counseling and male involvement. Target
groups include 11 through 19 year-old students, teen parents
and parents or other adult caretakers of teens.
Pennsylvania is using its abstinence education dollars to
develop a five year initiative. The five-year project called,
``Abstinence Education and Related Services'' or AERS is
currently funding 28 projects that cover 35 counties. In
addition to delivering an abstinence message, the program
includes mentoring, adult supervision, counseling and training
programs in abstinence education for teens, parents, peers and
health professionals.
Similarly, Michigan is funding 18 community-coalitions that
will provide an abstinence message that is geared to specific
local needs. The program places an emphasis on 9- to 14-year-
olds.
Florida is an example of a state that has included an
evaluation component. The state is evaluating five pilot
projects on different teen pregnancy prevention strategies,
including family life and sexuality education, medical and
mental health services, tutoring, job and career activities,
mentoring and community service activities. Parents are
encouraged to participate with their children. The programs
serve approximately 1600 at-risk middle school teens. At the
same time, Florida has funded 17 statewide abstinence education
grants to a variety of community-based organizations.
There are many other efforts going on, Iowa provides long-
term ten year grants to communities for long term prevention
strategies and programs, Oklahoma is expanding existing health
department efforts to increase outreach, Arkansas has convened
a statewide youth conference as a part of its strategy. Efforts
are expanding across the country.
These are just a few examples of current state approaches
and strategies. APHSA will be happy to provide the committee
with our full report to be issued in the coming weeks.
We expect to see expanded investments of TANF funds,
greater coordination between state and local departments and
partnerships in the coming years. Thank you for the opportunity
to testify today.
State Teen Pregnancy Prevention and Abstinence Education Efforts
Background
One of the core purposes of the Personal Responsibility and
Work Opportunity Reconciliation Act of 1996 (P.L. 104-193) is
to prevent and reduce the incidence of out-of-wedlock
pregnancies. States may therefore use federal Temporary
Assistance for Needy Families (TANF) and state maintenance-of-
effort (MOE) funds for programs and services designed to
achieve this goal. The welfare reform law also added a new
formula grant program to Title V of the Social Security Act for
states to provide abstinence education, mentoring, counseling,
and adult supervision to promote abstinence from sexual
activity, particularly among those groups identified as most
likely to bear children out of wedlock.
According to a recent survey conducted by the American
Public Human Services Association, states are using TANF and
Title V resources for a variety of efforts to reduce out-of-
wedlock pregnancies, with a heavy emphasis on promoting
abstinence and reducing pregnancy among teens. Some states are
incorporating strategies into their TANF policies, such as
targeted case management services, while others are
specifically funding prevention programs. State human service
and health agencies are working with other public and nonprofit
agencies, community groups, health providers, and others to
develop and implement programs and activities to achieve this
goal.
Survey Findings
The APHSA survey asked two questions of states:
Can you describe how you designed TANF policy or
used TANF funds to reduce the out-of-wedlock birthrate or teen
pregnancy?, and
Can you give an example of how abstinence
education funds have been used in a strategy to reduce out-of-
wedlock birthrates?
All 50 states, three territories, and the District of
Columbia responded to the survey. According to responses, most
states are using TANF and/or Title V funds for both teen
pregnancy/out-of-wedlock birth prevention programs and teen
abstinence education. Specifically:
46 states reported funding teen pregnancy/out-of-
wedlock birth prevention programs with federal TANF or state
MOE funds;
45 states reported using federal Title V
abstinence education funds for abstinence programs;
12 states reported using TANF funds for abstinence
education, or combining TANF and Title V funds; and
11 states reported focusing solely on teen
abstinence using TANF funds, Title V funds, or both.
Range of Activities
States are using available federal and state resources for
a variety of activities to prevent teen pregnancy and out-of-
wedlock births and to promote teen abstinence, including:
Media campaigns
Intensive case management
Family planning referrals
Community-based education programs
Youth conferences
Parenting skills programs
Father involvement programs
After-school programs
Curricula for self-esteem building, abstinence
education, etc.
Teen support and education programs
Family life and sexuality education
Medical and mental health services
Tutoring, job and career activities
Mentoring and community service activities
Family cap and short work-exemption period for
TANF recipients
Statutory rape education and awareness
Parent/child centers
Family focus group
Statewide/Local Programs
Of the states funding specific teen pregnancy
prevention/out-of-wedlock birth programs, 16 indicated that
they are using funds to run statewide programs, 13 states
indicated that they are supporting local programs, and 14
states indicated that they are supporting both statewide and
local efforts. (The total does not equal 46 because combined
teen pregnancy/abstinence programs are listed under
abstinence.)
Connecticut is using a combination of state and TANF funds
to support eight teen pregnancy programs. These programs
attempt to address a range of services and supports.
Pennsylvania, as part of the governor's ``Project for Community
Building,'' is implementing a statewide, five-year plan to
promote abstinence to adolescents. Rhode Island coordinated a
state strategy by bringing together the Departments of
Children, Youth and Families, Health, Education, and Human
Services. The multifaceted effort has focused on ``Positive
Asset Development'' in youths. The statewide plan also includes
a media campaign, a male-responsibility project, and the use of
male role models. Utah has used TANF funds for training staff
engaged in case management, teaching workers how to bring up
family planning services and how to use resource and referral
techniques.
While these statewide approaches involve the participation
of local parties, other states have sent funds directly to the
local level. Many times these funds are awarded by requests for
proposals (RFP); some states award money by formula. Most of
Colorado's 63 counties have some prevention efforts underway.
Services include programs to develop parenting skills, father
involvement, and family planning services. Virginia has
recognized 50 coalitions in more than 100 communities by
distributing $1 million in TANF funds. These coalitions were
required to conduct local community meetings on out-of-wedlock
births and submit a resolution to their local elected body
agreeing to make efforts to reduce the out-of-wedlock
birthrates. The state has also committed to pass along any
federal bonus funds to the communities that reduce their rates
the most. Wisconsin established criteria for abstinence-only
education grants and funds were awarded to the 13 local
programs that met those criteria. New York transferred $7
million in TANF funds to the Department of Health to be
targeted to programs of community health education and outreach
and to community-based adolescent pregnancy prevention
programs. The Oregon STARS (Students Today Aren't Ready for
Sex) program for high school and middle school students is a
school-based curriculum available in most of the state's
schools. The program's focus is to engage teens in a discussion
on sexuality and parenthood. South Carolina has set aside $10
million in TANF funds to be provided to each of the state's 46
counties over a three-year period. The programs to reduce out-
of-wedlock rates will be developed to reflect local community
values. Louisiana has targeted the New Orleans area due to its
high out-of-wedlock birthrate. As part of the state's strategy
it has awarded 10 contracts to develop school-and community-
based projects.
Abstinence-Only Approaches
Of the states funding abstinence education, nine
indicated that they are using funds to run statewide programs,
18 states indicated that they are supporting local programs,
and 19 indicated that they are supporting both state and local
efforts.
Arizona is using $2 million in TANF funds and combining
these dollars with its Title V funds into a single abstinence-
only program. The program includes a media campaign and
evaluation component and a variety of abstinence curricula.
Funds are awarded to local groups. The District of Columbia's
Public Health Department has developed a collaborative effort
around the abstinence approach. The department is working with
a number of groups including the Mayor's Committee to Reduce
Teen Pregnancy and Out-of-Wedlock Births and the Metropolitan
Police Boys and Girls Clubs. They are participating in the
``I'm Worth the Wait'' education curriculum. The District plans
to involve 10 additional organizations and agencies in the
effort. Massachusetts has developed the ``Abstinence Education
Media Campaign.'' A series of television and radio ads were
developed and aired with a target audience of 9- to 14-year-
olds. The ads also target parents of teens. The state is
building on that effort by adding a parent education film,
facilitator's guide, and youth and parent brochures and
posters. A number of planned community events and messages
educate youths about the relationship of alcohol and other
substances to sexual assault and the ability to remain
abstinent. Michigan is using its funds to assist 18 community
coalitions that have developed and implemented community-
specific education, outreach, and awareness activities targeted
to 9- to 14-year-olds. Maine has developed a media campaign
targeted to parents of teens in an effort to increase parent-
teen communication. The media campaign is reinforced with
information packets to parents providing tips on how to talk to
their children about sex.
Media Campaigns
12 states reported that they are using media
campaigns as part of their teen pregnancy/out-of-wedlock birth
prevention efforts and 26 states reported that they are using
media campaigns as part of their abstinence education programs.
(Many of these states used Title V funding, but four states
reported that they combined TANF and Title V Funds for a
campaign.)
States have increasingly turned to the media in their
efforts to reach ``Generation Y.'' These campaigns are usually
part of a larger strategy and are intended as an ongoing
effort. In a recent study, Delaware found that more than 68
percent of its residents have seen the messages being conveyed
by its media campaign on abstinence. The Delaware campaign uses
radio, billboards, print media, and bus tags with an emphasis
on getting parents to communicate with their children about
abstinence. Mississippi joined forces with a local marketing
research firm that provided pro bono services. The
collaboration resulted in a multimedia ``Just Wait'' campaign
that includes a 16-minute documentary called ``Heat of the
Moment.'' The documentary offers advice from teens to teens
about the results of teen pregnancy. Wyoming has combined the
use of TANF and Title V funds in an abstinence campaign.
Wyoming has targeted 9- to 14-year-olds with a radio and
television campaign. The message's secondary target is parents
and older siblings. A toll-free telephone number is also part
of the strategy.
Appointed Councils
Two states reported that they have councils or
committees appointed by the governor specifically to develop
teen pregnancy/out-of-wedlock birth reduction and/or abstinence
programs.
The governor of Arkansas appointed a 10-member steering
committee and hired an abstinence coordinator to develop a
strategy. One result of this effort was two statewide
conferences in November 1997 and May 1999. A 25-member
legislatively appointed committee also was created to assist in
the development of a pregnancy-prevention strategy. In Idaho
the governor has created a 15-member council on Adolescent
Pregnancy Prevention, comprised of members of key state
departments, private business, health care professionals, and
adolescents. The council has three subcommittees targeted to
infrastructure, educational resources, and media strategy.
Evaluation Efforts
13 states indicated that they are using funds to
develop and implement evaluation methods for statewide and
local abstinence and/or teen pregnancy prevention/out-of-
wedlock birth programs.
Florida is funding five pilot projects on teen pregnancy
prevention strategies and at the same time evaluating the
different approaches. Built into Iowa's abstinence education
grant program is an evaluation of its four school-based
curricula. Rhode Island has built an evaluation component into
its Male Responsibility Project. The program aims to prevent
``too-early'' fatherhood and the projects will be evaluated on
their capacity to achieve specific outcomes such as increased
abstinence, increased condom use, increased school attendance
and improved grades, and improved access to medical care. A
decrease in negative risk-taking behaviors and other measures
are also part of the evaluation process.
Family Planning Services
15 states reported that they are including family
planning and sex education in their teen pregnancy/out-of-
wedlock birth prevention programs.
California has used TANF funds for a Family Planning
Information Project for TANF recipients. The goal of the
project is to educate all audiences about the availability of
free and low-cost services. An advertising campaign that also
reaches the general population is part of this effort. Alaska
has targeted areas with high teen pregnancy birthrates and high
numbers of unintended pregnancies. The services include a fee
system that enables women with incomes lower than 200 percent
of poverty, who are not receiving Medicaid and have no other
source of insurance, to receive these services at no cost. As
part of a major coordinated effort between the Department of
Health and the Department of Human Services, Ohio has allocated
$250,000 of TANF funds for family planning services targeted to
the prevention of out-of-wedlock births. Kentucky has
transferred funds into Title XX, the Social Services Block
Grant, to provide family planning and a range of other
prevention services.
Males and Teen Fathers
Four states have targeted males or teen fathers
for special services or prevention efforts.
Georgia has funded 28 statewide comprehensive programs
funded from $3.9 million in TANF funds. These programs include
some that target the male population. These programs for males
promote responsible behavior, responsible fatherhood, and
abstinence. Indiana uses a combination of federal and state
TANF funds for a local grant program, the ``Restoring
Fatherhood'' initiative. Maryland has invested approximately $1
million over three years to serve 150 families through the
``Responsible Choice Home Visiting/Father-Involvement
Program.''
Case Management for Target Populations
24 states reported that they are including case
management of TANF recipients or high-risk teens in their teen
pregnancy/out-of-wedlock birth prevention programs.
As part of its case management services, Vermont provides
information about the financial and emotional impacts of teen
pregnancy and parenting. Ohio's Learning Earning and Parenting
(LEAP) program is a case management program that pre-dates
welfare reform. LEAP targets teen mothers with a goal of
keeping them in school and preventing a second birth.
Missouri's Teen Education Attainment Model (TEAM) is a school-
based case management program that targets high-risk teens with
special support services to assist them in obtaining a diploma.
Specific State Programs
For each state, the initiatives listed under the heading
``Teen Pregnancy Prevention'' or ``Teen Pregnancy Prevention/
Out-of-Wedlock Birth Reduction'' describe the use of TANF
funds, while the initiatives listed under ``Abstinence
Education'' describe the use of Title V funds. Where TANF funds
are used for abstinence education or TANF and Title V funds are
combined, the initiatives are listed under the heading ``Teen
Pregnancy Prevention/Abstinence Education.'' If a state is not
currently using TANF or abstinence education funds, no heading
or initiatives are listed. This does not indicate that
prevention efforts are not taking place but that the state is
using other departments or funds (such as public health) to
pursue prevention strategies.
Alabama
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Alabama's TANF program provides family planning information and
referrals to applicants and recipients of its Family Assistance
and JOBS programs. Eligibility is not dependent on acceptance
or use of family planning.
Abstinence Education. Abstinence funds are being used for a
media campaign and to support local projects selected and
evaluated by a state advisory committee.
Alaska
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Unintended Pregnancy Prevention Initiative is a strategy to
reduce unintended births to low-income, unmarried women through
an extensive outreach and education campaign. Family planning
clinical services target areas with high birthrates, high
numbers of teen births and births to unmarried women, high
numbers of unintended births to all ages, and births to teens
and women on Medicaid. The family planning services include
development of a capitated fee system that enables women whose
incomes are at or below 200 percent of poverty, and who are not
receiving Medicaid and have no other insurance available for
family planning services, to receive these service at no cost.
In addition, the Statutory Rape Education Program is being
designed to work with employers and government entities to
provide education on the problem of statutory rape. A media
campaign of statewide television and radio broadcasts will
begin in July 1999, focusing on parent-child communication
about sex, males and statutory rape, males and child support
enforcement, contraception, teens and HIV, and the importance
of teen pregnancy prevention and general awareness.
Abstinence Education. All abstinence education funds are
given to local communities as grants for various abstinence
programs and initiatives.
Arizona
Teen Pregnancy Prevention/Abstinence Education. Arizona is
using $2 million in TANF funds combined with Title V abstinence
funds for a single program. These funds are used to support a
media campaign and to support and evaluate community-based
service programs targeting youths, their parents, and adults
who work with youths. The message in the education and media
components is ``abstinence until marriage.'' Grantees are using
a variety of abstinence curricula and the media campaign
consists of three television spots, two radio spots, two
brochures, and a web site.
Arkansas
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Arkansas established a 25-member legislatively appointed
committee to develop teen pregnancy prevention programs and
hire a program coordinator. Arkansas has formed a 15-county
coalition to identify and implement strategies to reduce out-
of-wedlock births. TANF funds were used to hire a technical
assistance/evaluation provider to assist the counties with
their projects. The state also held a statewide youth
conference on Unwed Teen Pregnancy Prevention in December 1998,
and began a new media campaign in February 1999. The campaign
featured locally developed spots with 10 television and 40
radio stations. Three grantee training sessions were also
sponsored to assist in developing strategies for youth
conferences, coalition building, and other activities.
Abstinence Education. The governor of Arkansas has
appointed a 10-member steering committee and hired an
abstinence education coordinator. Arkansas used federal funds
to hold statewide conferences on abstinence education in
November 1997 and May 1999, and awarded 16 education grants
from March through December 1998. The state expects to award 19
grants in 1999. A statewide media campaign on abstinence
education was initiated in February 1999.
California
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
California has used TANF funds for a Family Planning
Information Project for welfare recipients. The goal of the
project is to educate all audiences about the availability of
free and low-cost family planning services. Information is
distributed at county welfare offices and through general
population advertising campaigns.
Colorado
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Colorado is a county-administered state; therefore it has no
single statewide teen pregnancy prevention program. However,
most of its 63 counties are investing TANF or state and county
MOE funds in a variety of services designed to improve
parenting skills, promote father involvement, promote child
development, and prevent teen pregnancies.
Teen Pregnancy Prevention/Abstinence Education. Colorado
counties are also using TANF funds for a variety of abstinence
education efforts. For example, Larimer County has budgeted
$29,000 to help address the problem of unwed pregnancies by
providing financial assistance for family planning supplies and
increasing outreach to women in low-paying jobs to improve
awareness of family planning options.
Connecticut
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Connecticut Department of Social Services is using a
combination of both state and TANF funds to support eight teen
pregnancy prevention programs throughout the state. These
programs follow a model designed by Dr. Michael Carrera, who
serves as a consultant and technical advisor on teen pregnancy
prevention. These programs are dedicated solely to primary
prevention of teen births (first-time births). The Carrera
model involves comprehensive, long-term, intensive programming
for adolescent and pre-adolescent girls and boys. It emphasizes
education, providing academic support to help youths succeed
and stay in school; career preparation, including work
experience and community service; family life and sexuality
education; and recreation.
Delaware
Teen Pregnancy Prevention/Abstinence Education. Delaware
has continued its media campaign, using billboards, print,
radio, and bus tags advocating abstinence and increased
parental communication with their children regarding sexuality.
A recent study reported that more than 68 percent of all
Delaware residents have seen the messages. Funding has also
gone to community groups in targeted communities and for mini-
grants to promote abstinence through a variety of after-school
and parent-child retreat activities. Efforts to reduce out-of-
wedlock births have included statewide conferences with
recognized speakers, bringing together leaders of community-
based organizations to address this issue. Planning is underway
to develop a comprehensive youth development program in the
state's urban areas with high rates of teen pregnancy. This
project plans to pool resources from all major funding streams,
including TANF, Title V, Title X, state funds, etc.
The District of Columbia
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The District of Columbia is using TANF funds to provide
assessment and ongoing case management for teen parents and
their children. Pilot projects will engage youths in after-
school programs, promoting academic and personal development,
and encourage parental involvement in the lives of their
adolescent children.
Abstinence Education. The DC Department of Public Health's
Abstinence Education Project has developed an ongoing
collaborative partnership with other youth service agencies.
The Department of Recreation's Youth Intervention Division,
Planned Parenthood, DHS, the Mayor's Committee to Reduce Teen
Pregnancy and Out of Wedlock Births, and the Metropolitan
Police Boys and Girls Club participate in training to teach the
``I'm Worth the Wait'' abstinence education curriculum to the
youths in their programs. The District plans to link an
additional 10 agencies and organizations to this program. Over
a four-month period, the Abstinence Education Project has also
provided 360 DC public school students with abstinence
education and information through classroom education sessions.
Florida
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Florida is evaluating five pilot projects on teen pregnancy
prevention. These projects are holistic models that provide a
comprehensive range of services designed to give youths a
``vision of a future.'' Program components include family life
and sexuality education, medical and mental health services,
tutoring, job and career activities, mentoring, and community
service activities. Each program includes instruction and
emphasis on the value of abstinence. Parents of at-risk teens
are encouraged to participate with their children. The programs
serve about 1,600 at-risk middle school teens.
Abstinence Education. The Department of Health has awarded
17 state-wide abstinence education grants to community-based
organizations, religious institutions, and public health
agencies for classroom instruction, after-school activities,
enhancing self-esteem, goal setting, decision making,
negotiation/refusal skills, counseling, life skills training,
peer education/mentoring, and parent education. Florida has
also funded a statewide media campaign targeting 9- to 14-year-
olds, their parents, and the community, to encourage abstinence
and reduce the out-of-wedlock birthrate.
Georgia
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Georgia's Adolescent Health and Youth Development program has
28 statewide comprehensive programs funded from TANF funds
totaling $3.9 million. Programs are aimed at reducing risk
behavior and poor health outcomes. Male involvement programs
are aimed at promoting responsible behavior, fatherhood, and
abstinence; community involvement as the mechanism for the
direct involvement of parents, youths, and others in promoting
positive youth development; and outreach activities designed to
create awareness and access among hard-to-reach youths and
their families. TANF recipients are also required to sign a
Personal Responsibility Plan for themselves and members of
their households. Policy requires that all children in the
household age 13 and older attend family planning counseling
that includes a wide pregnancy prevention messages.
Abstinence Education. Georgia receives $1.5 million in
federal funds for abstinence education activities and uses a
variety of strategies, including a media campaign designed to
motivate youths to abstain from sexual activity until marriage
and encourage parent-child discussion on appropriate and
expected sexual behavior and distribution of competitive grant
awards to youth-serving community organizations. More than 50
community-based organizations have been funded to initiate or
expand abstinence education efforts, including mentoring,
academic tutoring, recreational activities, character and
values clarification, relationship building, decision making,
and refusal skills.
Guam
Abstinence Education. The Department of Public Health and
Social Services administers the Abstinence Only Education (AOE)
program, funded by abstinence education funds. In FY 1999,
funds were used to conduct a ``Train the Trainers'' seminar on
the AOE project to educate program providers about strategies
for teaching adolescents and young adults, developing
curriculum, and conducting pre-and post-evaluations. The AOE
program coordinator is working with program trainers to begin
the Partnership for Abstinence Only to address the reduction of
out-of-wedlock birth rates. The AOE program coordinator also
collaborates with the health educator to distribute brochures,
pamphlets, and posters at mini-health fairs and conduct
educational sessions at various public schools.
Idaho
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Idaho is using TANF funds to support the Governor's Council on
Adolescent Pregnancy Prevention. The council is composed of 15
members from public health, education, and welfare agencies,
private business, adolescents, health care providers, local
officials, media, clergy, and parents. The council includes
three committees focusing on community infrastructure,
educational resources, and mass media campaigns. The council
intends to support local coalitions through guidance and
resource materials, training workshops, and assistance in
organizing community awareness efforts. A statewide media
campaign is focusing on various messages, from encouraging
parent-adolescent discussions to creating positive peer
pressure, to relating the legal obligations associated with
parenthood, as well as lifestyle changes. The slogan for the
campaign is: ``Sex lasts a moment, being a parent lasts your
whole life.''
Abstinence Education. Abstinence funds support the
development of community coalitions that work with the
Governor's Council on Adolescent Pregnancy Prevention to raise
awareness of the impact of adolescent pregnancy.
Illinois
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Illinois is using $4.4 million and $5 million in TANF funds in
state FYs 1999 and 2000, respectively, to support the Teen
REACH (Responsibility, Education, Achievement, Caring, and
Hope) program. The program seeks to provide structured
activities during out-of-school time to expand the range of
choices and opportunities that enable, empower, and encourage
youths age 10 to 17 to achieve positive growth and development,
improve expectations and capacities for future success, and
avoid and/or reduce risk-taking behaviors such as substance
use, criminal involvement, violence, and sexual activity. The
program tries to improve participants' academic achievement;
provide opportunities for demonstrating positive social skills,
instructions, and relationships through supervised sports,
recreation, and other program activities; provide opportunities
for demonstrating positive social behavior through adult and
peer mentoring; and encourage positive decision-making skills
that discourage negative risk-taking behaviors. An underlying
goal is strengthening parental involvement in the lives of
participating youths. Out-of-school programs are provided by
contracted agencies in selected communities across the state.
Abstinence Education. For state FY 1999 the department
contracted with 31 agencies in selected areas across the state
to address the instances of births to unmarried women,
especially teens. The goals of the Illinois Abstinence Only
Education program are to reduce the proportion of adolescents
who have engaged in sexual intercourse, incidence of sexually
transmitted diseases among teens 15 to 19 years old; fertility
rate among teens 15 to 17 years old; pregnancy rate among teens
15 to 17 years old; and the number of teen parents receiving
TANF in the state.
Indiana
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
TANF funds and MOE expenditures provide part of Indiana's
family planning funding and Restoring Fatherhood initiative
funding. Both programs grant funds to local community programs
to strengthen families and reduce the incidence of unplanned
pregnancies.
Abstinence Education. Indiana's abstinence education funds
are used for the Project RESPECT program which is run by its
state Department of Health. Project RESPECT is mainly a mass
media and education program to discourage teen pregnancy.
Because Indiana has two sources of funding for programs dealing
with teen pregnancy--federal abstinence education funds and
state funds from a line item in its health department budget--
local communities can select which funds they prefer to use.
Federal funds support organizations that stress abstinence
until marriage, while state funds support organizations that
stress abstinence throughout the teen years (and teach family
planning, contraception, etc.). Currently, 52 local youth-
serving organizations rely on federal funds, and 29 local
organizations rely on state funds.
Iowa
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Iowa has a nine-year-old Adolescent Pregnancy Prevention
Program that uses $760,000 of TANF funds and in state FY 2000
will support nine community groups that applied to work on
adolescent pregnancy prevention. The state also uses the money
for a statewide media campaign, a statewide coalition grant,
and a statewide evaluation grant for the community groups. Iowa
also uses TANF funds ($1.99 million) for family planning
services, available to teens based on income.
Abstinence Education. The Department of Health uses this
money for four school-based curriculum development grants, as
well as for funding an evaluation of those programs. A portion
of that money was also given to maternal child health clinics
that competed for grants.
Kansas
Teen Pregnancy Prevention/Abstinence Education. Kansas
requires the provision of intensive case management services to
teen parents who receive cash assistance. In state FY 2000,
$200,000 in TANF funding has been reserved to evaluate one teen
pregnancy case management project and one primary prevention
abstinence program. Both programs are currently operating in
the state. The remaining funds are earmarked for
transportation, child care, or other intervention strategies
that may lead to enhance program participation.
Abstinence Education. Kansas has developed an abstinence
education program with performance measures for the rate of
teen pregnancy, the percentage of out-of-wedlock births to
teens, and the rate of teen births fathered by men age 20 and
older. The abstinence education grant is administered by the
Department of Health and Environment.
Kentucky
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Kentucky transferred TANF funds to the Social Services Block
Grant for a variety of activities, including family planning
counseling in local health departments ($.5 million in state FY
1999 and a projected $1 million in state FY 2000), and
providing family planning information and pamphlets to local
welfare offices.
Teen Pregnancy Prevention/Abstinence Education. Abstinence
education funds were used to help support a statewide
television, radio, and poster campaign in 1998. Tagged ``Get a
Life First--Wait to Have Sex,'' the campaign promoted sexual
abstinence among teens. TANF funds are being used in 1999 to
support a new campaign titled ``If You Think You're Ready for
Sex, Are You Ready for This?'' The campaign focuses on the
consequences of sexual risk behaviors, and is also supported in
part by TANF funds.
Louisiana
Teen Pregnancy Prevention/Abstinence Education. The DSS has
initiated a pilot project to reduce teen pregnancy in the areas
of New Orleans with the highest teen birthrate. Ten contracts
were awarded to create school-and community-based programs.
Components of the project are youth development, comprehensive
health/family life education, parental involvement, mental
health/counseling, and male involvement. Target groups are 11-
to 19-year-old students, teen parents, and the adult parents/
caretakers of the teens. The agency has awarded a grant to the
Louisiana Initiative for Teen Pregnancy Prevention for a
statewide billboard campaign to promote communication between
parents and children regarding abstinence. The billboards will
be placed twice this year to coincide with the state and
national teen pregnancy prevention months. The agency is also
in the process of requesting proposals for a statewide media
campaign to provide education regarding teen pregnancy
prevention and to develop an awareness of the effects of teen
pregnancy on the family and society.
Maine
Abstinence Education. Maine's Abstinence Education Media
Campaign has focused on the need for parent-teen communication
about sexuality. Through TV spots emphasizing the importance of
such communication, and information packets for parents giving
tips on how they can talk with their teens about sexuality
issues, the media campaign has sought to reduce teen
pregnancies (most of which are to unmarried women). Maine also
has an ``Abstinence Works'' presentation for middle school
students, ``Positive Choices, Positive Futures'' for parents of
adolescents, and three community grants to community action
teams. The targeted age group is 9- to 14-year-olds (and their
parents), and an emphasis is placed on the cultural
appropriateness of the messages.
Maryland
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Maryland Department of Human Resources (DHR) will invest
approximately $1 million over three years to serve 150 families
through the Responsible Choice Home-Visiting/Father-Involvement
Program. This program serves young adults who are expecting
their first child and are receiving and/or grew up in a family
receiving cash assistance. The program aims to reduce
subsequent non-marital births, increase the employment rate,
and improve the long-term involvement of both parents in
rearing their child. The program follows the Healthy Families
America model for home-visiting services for prenatal and early
infancy home visits. On-site services are also offered
including GED and employment training, job search assistance,
and parenting classes. Biological fathers receive mediation
counseling, paternity establishment assistance, and peer
support groups in addition to the other services. Each program
site has a male involvement coordinator who oversees these
services.
Abstinence Education. The Department of Health and Mental
Hygiene uses abstinence education funds to help community
organizations collaborate on state media abstinence campaigns
and offer after-school youth development programs with
alternative activities. DHR sponsors the Best Friends program,
a sub-initiative of the Responsible Choices Demonstration
Project, which aims to prevent non-marital births by promoting
self-esteem, fitness, and community awareness to pre-teen
girls. The program will likely expand in the near future to
make eligible all fourth-and fifth-grade girls at DHR-funded
sites.
Massachusetts
Teen Pregnancy Prevention. Massachusetts has a continuum of
programs and services in place for women and adolescents to
assure good pre-conceptual health for women and to prevent teen
pregnancies. Programs include a variety of health services and
health promotion programs, including community-based prevention
activities to decrease teen pregnancy and other at-risk
adolescent behaviors. The Challenge Fund: Teen Pregnancy
Prevention Program provides funding to communities with high
teen pregnancy rates to develop a continuum of primary
prevention services intended to increase abstinence, delay the
onset of early sexual activity, and reduce the rate of teen
pregnancy and other related high-risk health behaviors among
adolescents.
Abstinence Education. Massachusetts funds abstinence-based
pregnancy prevention through in-school programs that target
middle-school youths. The goal is to delay the onset of sexual
activity in pre-adolescents and to increase the number of
youths who choose to remain abstinent through programs
specifically designed to increase resiliency and academic
skills. The Abstinence Education Media Campaign was developed
for abstinence-only programs through a federal grant under
welfare reform. The goal of the campaign is to increase the
number of youths who choose to remain abstinent. A series of
television and radio ads was developed and aired for pre-
adolescent males and females ages 9 to 14, with clear messages
that support abstinence outside of marriage and the benefits of
waiting. Messages encouraging parents to communicate openly
with their children about the importance of abstinence were
also developed and aired. During 1999, a parent education film,
facilitator's guide, and youth and parent brochures and posters
will be completed. In addition to a number of planned community
events, messages that educate youths about relationship of
alcohol and other substances to sexual assault and the ability
to remain abstinent will be produced and aired. All messages
are developed with the input of youths, parents, and other
local community members, and will be available in both English
and Spanish. A statewide advisory committee comprised of
parents, community members, and educational representatives
oversees the entire campaign.
Michigan
Abstinence Education. Michigan is using abstinence
education funds to support 18 community coalitions that have
developed and implemented community-specific education,
outreach, and awareness activities targeting 9- to 14-year-olds
as well as older teens. The activities aim to address the risks
of sexual activity and associated behavioral risks and
influence decisions to delay sexual activity among teens. Funds
are also being used to develop media messages targeting teens
and parents, and support a broad-based state-level partnership
of consumer, advocate, professional, and laypersons to
establish principles and practices guiding the use of
resources.
Minnesota
Teen Pregnancy Prevention/Abstinence Education. The
Minnesota TANF program, Minnesota Family Investment Program,
encourages personal responsibility and self-sufficiency. The
Minnesota DHS works in partnership with the Department of
Health and its efforts in abstinence education.
Abstinence Education. Minnesota's Education Now and Babies
Later (MNENBL) promotes abstinence education of adolescents
ages 11 to 14 with the goal of preventing future unplanned
pregnancies and dependence on assistance. The program supports
14 grantees.
Mississippi
Teen Pregnancy Prevention/Abstinence Education. Mississippi
DHS joined forces with a local marketing research advertising
firm that worked pro bono to develop a multimedia ``Just Wait''
abstinence campaign. The campaign included a 16-minute
unscripted documentary, ``Heat of the Moment,'' in which teens
offer abstinence to fellow teens as a real choice and solution
to the problems of teen pregnancy and sexually transmitted
diseases. The documentary and a set of posters extracted from
it have been distributed statewide to schools, libraries,
churches, and other youth-serving organizations. Organizations
from 22 states have used copies of the documentary. The
campaign also incorporated two public awareness campaigns (one
targeting parents and one targeting teens) that used radio and
television public service announcements plus purchased spots,
print ads, and billboards. The ``Just Wait'' abstinence unit
provides further abstinence-only materials and presentations
upon request. The state legislature passed a bill at the
recommendation of the Mississippi Task Force on Reducing Out-
of-Wedlock Pregnancies which states that abstinence education
shall be the state standard for any sex-related education
course in the state's public schools. The task force also
sponsored the first statewide Abstinence Works! Let's Talk
About It! Conference on May 4, 1999, which was cosponsored by
DHS, the Department of Education, Department of Health,
Mississippi State University Extension Service, and Mississippi
Family Council.
Abstinence Education. Abstinence education funds,
administered through the state Department of Health, have been
used to support community organizations that teach children
ages 10 to 19 the rewards of remaining abstinent until
marriage. The programs teach children the concepts of self-
esteem, self-discipline, and self-respect. Several programs
have held award ceremonies to reward those children who have
pledged to remain abstinent until marriage.
Missouri
Teen Pregnancy Prevention. Missouri uses TANF funds to
support the Teen Education Attainment Model (TEAM) program.
TEAM is a case management program based in local school
districts to assist at-risk teens in obtaining their high
school diploma. The TEAM program provides supportive services
to teens in the form of transportation reimbursement, child
care, training-related expense reimbursements, and case
management services. TEAM focuses its priorities on parenting
or pregnant teens as well as those at risk of dropping out of
school, and encourages teens to stay in school through
providing the program services.
Montana
Teen Pregnancy Prevention. A partnership project titled
``Communicating with Participants: An Introduction to Planning
A Family'' was initiated by the Women's Health Service (WHS) to
join efforts with the Public Assistance Bureau (PAB) of the
Department of Public Health and Human Services to reduce
unintended pregnancy in Montana. A trainer with extensive
experience with the Montana Family Planning network and state
teen pregnancy prevention was hired to develop the curriculum
and be the lead trainer. The WHS was able to leverage a $24,000
special initiative Title X partnership grant to obtain an
additional $50,000 from TANF funds for this project. This
partnership created a training system for organizations to
foster low-income families' abilities to make informed
decisions about planning a family. In addition, the established
curriculum will be used to develop other statewide partnerships
to promote family planning referrals from agencies that deal
with low-income clients at risk for an unintended pregnancy and
in need of public assistance. Subsequently, family planning
trainers could train other personnel, such as public health
home-visiting nurses.
Abstinence Education. The Title V abstinence education
funds have not specifically been used to reduce out-of-wedlock
birthrates. Rather, $60,000 was granted to five communities
around the state to address the need for parenting education
programs. These parent-based programs will focus on
``abstinence until marriage'' for the targeted youth
population.
Nebraska
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Nebraska has two specific initiatives in its Aid to Dependent
Children (ADC) program that are designed to reduce out-of-
wedlock pregnancies. The first is a family cap that does not
permit the normal increase in an ADC grant when a child is born
10 months after the applicant or client is informed of this
policy. In addition, the state only permits a 90-day exemption
from the employment requirements of the Employment First
program for those who expand their family.
Abstinence Education. Abstinence education funds have been
used for a public education campaign with the theme ``Friends
First, Friends Forever'' (based on input from a state Youth
Forum). The state also awarded funds, curricula, training, and
technical assistance to six communities with the highest levels
of teen births in 1997 to develop community-specific strategies
promoting abstinence until marriage. Each community was offered
a choice of curricula as well as technical assistance. The
state has developed an evaluation component to measure the
effectiveness of these programs.
Nevada
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Nevada Welfare Division has contracted with the University
of Nevada to develop a two-hour training curriculum, manual,
and compressed video designed to reach state and local law
enforcement officials, the education system, and relevant
counseling systems that provide education and training on the
problems of statutory rape. Teenage pregnancy prevention
programs may be expanded to include men. The Welfare Division
has reviewed the final TANF regulations and will be holding a
Request for Information to obtain community interest in Teen
Pregnancy Prevention Programs.
New Hampshire
Teen Pregnancy Prevention. TANF funds have been used to
fund three home visiting projects serving pregnant women under
25 and their children (up to 2 years old). Many teen mothers
are served and one goal is to reduce subsequent pregnancies
among that population.
Abstinence Education. New Hampshire will use abstinence
funds to conduct a media campaign geared toward young
adolescents, stressing abstinence and pregnancy prevention.
New Jersey
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
New Jersey has established a Work First New Jersey (WFNJ)
Inter-Departmental Adolescent Pregnancy Prevention Work Group
that promotes collaboration across various state departments
and oversees a statewide hotline and two mentoring programs
funded by TANF, collectively known as the Adolescent Pregnancy
Prevention Initiative (APPI). WFNJ hosted the inaugural
Adolescent Pregnancy Prevention Month statewide planning
meeting involving more than 200 stakeholders from across the
state. The session provided ``how to'' information for planning
local adolescent pregnancy prevention month events. WFNJ also
hosted a Statewide Adolescent Pregnancy Prevention Month Pep
Rally to raise awareness of the adolescent pregnancy prevention
efforts in New Jersey. In total, $1.1 million in TANF funds is
devoted to adolescent pregnancy prevention efforts. The School-
Based Youth Services Program (SBYSP) operates in 30 urban,
rural, and suburban school districts, to provide teens with a
comprehensive set of services in health care, mental health and
family counseling, job and employment training, and substance
abuse counseling. Many SBYSPs also offer on-site child care,
enabling teen parents to remain in school, attend parenting
classes, and prevent subsequent pregnancies. The Pinelands
SBYSP has been successful in reducing pregnancies from an
average of 20 per year (prior to program implementation) to an
average of 1-3 pregnancies per year, for the last eight years.
TANF teen pregnancy prevention funds are also allocated to a
hotline which takes calls 24 hours per day and focuses on teen
issues (specifically teen pregnancy prevention). This hotline
is promoted through posters, wallet-size cards for youths, and
a public service announcement (PSA) that has been distributed
to radio and television stations. The PSA is also being
distributed to local movie theaters.
Abstinence Education. The New Jersey Department of Health
and Senior Services (DHSS) oversees the abstinence education
projects, which are designed to teach pre-teens and teens the
benefits of abstinence. During July 1998, DHSS awarded grant
funds for projects to develop or expand youth groups and train
peer educators; develop or expand community-based education
efforts on the benefits of abstinence, refusal skills,
communication, and decision-making skills targeting at-risk
youths; local or regional mentoring programs; and parenting
skills training including communications skill building and
education on sexuality and the benefits of delaying sexual
activity for youths.
New Mexico
Abstinence Education. New Mexico has focused its efforts on
young children (elementary and middle school age) in an effort
to build social assets according to Peter Benson's positive
choices curriculum. This is a form of primary prevention which
combats not only out-of-wedlock births but also other high-risk
behaviors like drug use and gang membership. New Mexico has
also designed after-school programs, and has trained health
educators in local health offices to teach abstinence in school
and parent settings. The state also has a marketing program,
the cost of which is split between Medicaid and Title V. It
publishes a free teen magazine, ``Not Yet: Wait to Have Sex,
Wait to Have a Baby,'' which is designed to be fun for
adolescents. The marketing program also makes t-shirts,
baseball caps, and pins and has developed multiple videos
linking teen pregnancy and other high-risk behaviors. A recent
New Mexico responsible sexuality segment won an Emmy Award.
New York
Teen Pregnancy Prevention/Abstinence Education. In state
FYs 1997-1998, New York transferred $7 million in TANF funds to
the Department of Health to target programs of community health
education and outreach and community-based adolescent pregnancy
prevention to prevent unintended pregnancy in adults and
adolescents eligible for TANF assistance. The funds were used
to significantly expand the Department's Community-Based
Adolescent Pregnancy Prevention Program (CBAPP) and the
Comprehensive Family Planning and Reproductive Health Program.
CBAPP works with communities, providing information and
education, promoting abstinence, expanding educational and
recreational opportunities for teens, and providing access to
comprehensive reproductive health care services to sexually
active teens. Funding was also provided to 65 family planning
agencies with more than 230 service sites.
Abstinence Education. The Department of Health has
purchased the Not Me, Not Now media campaign developed in
Monroe County. The campaign runs from fall 1998 to fall 1999
and features television, radio, billboard, and bus ads. The
department also began a community-based component with
approximately $5.6 million in federal and state matching funds.
This program will provide community information, abstinence
education, outreach to high-risk youths, and services to young
males.
North Carolina
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
North Carolina is conducting a statewide media campaign and
training initiative with the message: ``Parents, talk to your
children about sex.'' The state is funding training events and
programs for professionals who work with children, as well as
supporting the development of an evaluation system for teen
provider programs. Other efforts include supporting adolescent
parenting and prevention programs and local coalition programs.
For state FY 1999, $2 million of the TANF block grant was
targeted to these programs.
North Dakota
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
North Dakota requires parenting skills training for adult
recipients of its cash assistance program when deemed
appropriate, and provides education programs for dependent
children. The state aims to address the immediate problem with
teens and to work on the long-term effort to break the welfare
cycle.
Abstinence Education. Funds are granted to local government
and public entities for a wide range of abstinence education
including media campaigns and health education programs in
local schools.
Ohio
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Ohio Wellness Block Grant is a statewide initiative, with
each of the state's 88 counties receiving funding to reduce
teen pregnancy. The target population is youths between the
ages of 10 and 19. Each local Family and Children First (FCF)
council has identified specific subpopulations within this age
range for services. The Department of Youth Services receives
an allocation as Ohio's 89th county due to the high rate of
teen pregnancy in its incarcerated population. Local FCF
councils have responsibility for planning, priority setting,
selecting prevention strategies, allocating resources,
monitoring programs, and tracking results. Program activities
include mentoring programs, asset building, peer support
programs, resource libraries, teen help hotlines, teen
parenting programs, media campaigns, and home visitation
services. Local councils report that awareness about teen
pregnancy among public agencies and local service providers has
substantially increased, that many nonprofit agencies are
working more collaboratively, and that schools are becoming
more connected to social service organizations. The Ohio
Learning, Earning and Parenting (LEAP) program is a statewide
initiative, designed to help teen parents complete high school
and reduce the incidence of second pregnancies. The LEAP
program combines support services with case management, and
incentives for school attendance, grade completion, and
graduation, with penalties for non-attendance. The LEAP program
affects about 8,000 teen parents each year. In the last three
years, Ohio has combined efforts with Early Start (a home
visiting program) to provide additional services to teen
parents to assist with pregnancy prevention and care of young
children. In the fiscal year beginning July 1999, the Ohio
General Assembly created the Ohio TANF Family Planning Program.
It will provide $250,000 of TANF funds for pre-pregnancy family
planning services designed to prevent out-of-wedlock births.
This is a joint effort between the Ohio Department of Health
and the Ohio Department of Human Services.
Abstinence Education. The Ohio Department of Health
administers the abstinence education program and provides
funding to 34 (in state FY 1999) agencies to conduct
programming in school settings. Funded agencies include
community-based and youth-serving organizations that have not
traditionally received funds from the department; local health
departments; local school districts; hospitals; an FCF council;
a county department of human services; and a prosecuting
attorney''s office. Program activities include age-appropriate
curricula and presentations to teach abstinence from sexual
activity and other associated risk behaviors for unmarried
teens. Social skill instructions, character-based education,
asset building to promote self-esteem, as well as parent
education, are other program approaches that agencies use in
reaching youths.
Oklahoma
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Family Support Services collaborated with the Health
Department to expand and develop already existing teen
pregnancy outreach programs. The new program hires TANF
recipients as outreach workers who target high-risk teens and
families. This is currently a pilot program in a few counties.
TANF dollars also help to fund programs that specifically
target first-time mothers, hoping to reduce the chance of a
second birth.
Abstinence Education. Oklahoma installed an abstinence
curriculum in high schools in six counties. Each county can
choose its own curriculum, but the most popular is called
Facing Reality. Four of the projects have finished their first
year, and about 1,000 teens have participated in the
curriculum. Approximately 850 of those were evaluated by the
University of Oklahoma's Institute for Public Affairs.
Oregon
Teen Pregnancy Prevention/Abstinence Education. The Oregon
Adult and Family Services (AFS) Division of the Department of
Human Resources has worked with and provided funds to local
organizations to help offer pregnancy counseling to teens and
raise awareness of the risks and dangers of unwed parenthood.
TANF funds have been used for the Students Today Aren't Ready
for Sex (STARS) program. STARS is an abstinence-based teen
pregnancy prevention curriculum in which teen leaders from high
schools teach sixth-and seventh-graders how to identify and
resist pressures that lead young people into premature sexual
involvement. The program reached about 29,000 students during
the 1998-1999 school year. The Reduce Adolescent Pregnancy
Partnership (RAPP) is a network of local coalitions dedicated
to preventing teen pregnancy. The goal of RAPP coalitions is to
solidify comprehensive teen pregnancy efforts by both local and
state partners by providing leadership, support, and assistance
throughout the state to meet the Oregon benchmark with regards
to reducing teen pregnancy. In addition to these community
services, AFS contracts with local partners (such as community
colleges, etc.) to provide parenting classes and counseling to
teen parents. The partners provide information regarding
sexuality and subsequent pregnancy prevention as part of the
classes and counseling. AFS case managers enter into
discussions with teen parents as often as the situation permits
and encourage them to take steps to ensure against subsequent
pregnancies.
Pennsylvania
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Pennsylvania is focusing on the issue of teen pregnancies that
result from relationships with older men through a Statutory
Rape Task Force and a contract with the Pennsylvania Coalition
Against Rape (PCAR). The state launched an ad campaign and
educational program to increase awareness of the statutory rape
laws among middle school, junior high, and high school students
and staff. The campaign features posters, a teen magazine, a CD
of songs about teens in various relationship situations, and
free concerts at underage dance clubs.
Abstinence Education. The Pennsylvania Department of
Health, through the Abstinence Education and Related Services
(AERS) Initiative, and as part of the Governor's Project for
Community Building, is implementing a five-year comprehensive
statewide plan to promote abstinence as a positive lifestyle
decision for young adolescents. Currently 28 AERS community-
based projects serve 35 counties. The projects will deliver
abstinence-only education and related services to children and
adolescents throughout communities and schools. Services
include mentoring, adult supervision, counseling, and training
programs for parents, peers, and health professions on how to
conduct abstinence education. A statewide media campaign is
also planned to raise public awareness of the benefits of
abstinence, the negative consequences of teen pregnancies
outside marriage, and the central role of parents and
significant others as the prime educators of their youths.
Puerto Rico
Abstinence Education. Puerto Rico has developed the Puerto
Rice Abstinence Education Program (PRAEP) to reduce teen
pregnancy. Its philosophy is abstinence as the only alternative
that is 100 percent effective in reducing teen pregnancy and
sexually transmitted diseases. The program includes a ``Sex Can
Wait'' curriculum developed by the University of Arkansas which
was implemented in public schools from grades 5 to 12. The
program will also include peer groups to promote sexual
abstinence using character development strategies. In total,
PRAEP has reached 58,182 Puerto Rican adolescents. A mass
communications media campaign was being developed by students
during a summer camp in June 1999, and coalitions around the
island including students, parents, teachers, health
professionals, local entrepreneurs, and others will develop
customized socio-recreational activities for their communities.
Rhode Island
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Rhode Island Departments of Children, Youth and Families,
Health, Education, and Human Services are collaborating on a
comprehensive statewide plan to reduce the incidence of teen
pregnancy. The efforts focus on ``Positive Asset Development''
of youths, and incorporate a holistic approach to youth
development conveyed through strong, appropriate relationships
with caring adults. The statewide plan supports statewide and
local efforts and includes media campaigns for teen pregnancy
prevention, family planning, and sex education. The Department
of Health is funding a monitoring program. Rhode Island has
also initiated the Male Responsibility Project through the
Department of Human Services. Services are provided by male
counselors from five community-based organizations that also
serve pregnant and parenting adolescent girls. The program aims
to prevent ``too-early'' fatherhood, and the individual
projects will be evaluated on their capacity to achieve
specific outcomes such as an increase in abstinence, increase
in use of condoms, increase in school attendance and grades,
improved access to medical care, decrease in negative risk-
taking behaviors, and other measures. The five projects will
operate in 10 cities and towns including the five core cities
with the highest rates of teen pregnancies. Others are rural,
suburban, and small town areas.
Abstinence Education. The Department of Health is using
federal abstinence education funds for a program that provides
training and support for male role models. The project is being
implemented in four areas with the highest teen pregnancy rates
in Rhode Island. The state also runs an after-school program
for middle-school adolescents, but is funding it with resources
other than the federal abstinence education funds.
South Carolina
Teen Pregnancy Prevention. During the 1998 legislative
session, the South Carolina General Assembly passed legislation
that created the County Grants Fund for Adolescent Pregnancy
Prevention Initiatives. This was funded with $10.5 million of
TANF funds, intended to be distributed to each of South
Carolina's 46 counties over a period of three years. The
purpose of the fund is to support local efforts to prevent
early sexual activity and to measurably reduce the rate of
adolescent pregnancy in each county. Programs developed will
reflect local and community values. Additionally, all
initiatives funded will emphasize premarital sexual abstinence
and male responsibility.
South Dakota
Abstinence Education. The South Dakota Department of Health
gives subgrants to communities to design their own abstinence
projects. The department itself approves the projects and
provides oversight.
Tennessee
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Tennessee gave $300,000 in grants to 30 counties with the
highest number of out-of-wedlock births. All four large urban
counties have teen pregnancy parenting/prevention programs as
do several rural counties as well. Strategies for these
programs include mass media campaigns, focus groups, and
others. Teen programs use individual and group case management
in and out of school with teen parents. The message of these
programs is stay in school, be a good parent, plan a career,
and prevent additional unplanned pregnancies.
Abstinence Education. The Tennessee Department of Health
awarded grants to local schools, nonprofit organizations, and
community groups for abstinence education efforts.
Texas
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Texas has funded four pilot projects that provide residential
and non-residential services targeted to teen parents that
include counseling and parenting skills classes. Additionally,
Texas funds programs that provide prenatal intervention or at
birth with high-risk families. Teens identified at this point
of intervention receive parent education, training, and
counseling services that encourage families to think about
their ability and desire to provide adequately for additional
children, and actively link them to family planning services.
Some of these programs specifically target teen parents for
their service delivery to help reduce the number of additional
teen pregnancies. The Texas Workforce Commission, in
collaboration with the Texas Department of Human Services and
the Texas Department of Protective and Regulatory Services, is
involved in a Second Chance pilot program to reduce and prevent
the problems teen parents and their children face and to break
the cycle of welfare dependence. The program will provide
independent living services and licensed adult-supervised
living arrangements to teen parents and their children who
receive TANF assistance. Under this program, a teen parent not
living with a parent, legal guardian, adult relative, or in a
licensed adult-supervised living setting, and applying for
TANF, will be referred to the program provider. The provider
will assess the needs of the teen parent and either work with
other agencies to ensure those needs are met, or provide the
needed services themselves.
Abstinence Education. Texas held an Abstinence Education
Conference in July 1998 that was open to abstinence education
contractors and to the general public. It has funded 32
entities to provide abstinence education, with activities that
include classroom instruction and/or assemblies; counseling;
mentoring; after-school activities like field trips, dances,
resource library, computer dolls, retreats, community
involvement, web sites, home liaisons, and a hotline; peers as
teachers; and media campaigns.
Utah
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Utah has used TANF funds for six pregnancy prevention contracts
across the state. It also uses the money for statewide training
for all staff engaged in case management, teaching them how to
bring up family planning with customers, and resource and
referral techniques.
Abstinence Education. Utah has given abstinence education
funds to 11 community-based projects in various parts of the
state, targeting 9- to 14-year-old youths (both boys and
girls). The state views abstinence only as one part of a
continuum of pregnancy prevention education, particularly
appropriate for that age group. The projects take place in
school, after school, and in private settings. Some curricula
are standard, such as ``Sex Can Wait'' and ``Postponing Sexual
Involvement.'' Other curricula are more unique to the locality.
Vermont
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
Vermont provides TANF recipients with individualized case
management that focuses on helping families reach goals they
have set for themselves. Information about the financial and
emotional impacts of teen pregnancy and parenting with a
partner is included. In addition, TANF funds support a network
of parent/child centers that include a focus on preventing
initial teen pregnancies and promoting stable families.
Abstinence Education. Funds were used to hold focus forums
with families, design and pilot test an abstinence promotion
media campaign, and provide fulfillment materials in response
to the PSA. The campaign targets families of middle-school and
young high-school students, stresses the connection of
substance use and unintended sexual activity, and promotes the
importance of parent-child communication.
The Virgin Islands
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
The Virgin Islands is funding television and radio
advertisements designed to prevent teen pregnancy and enhance
responsibility and accountability among teens. It provides
social work services to TANF recipients and young mothers in an
effort to prevent and reduce teen pregnancy.
Virginia
Teen Pregnancy Prevention. In 1997, Virginia offered TANF
funds to coalitions across the state who joined its ``The
Commonwealth and You: Partners in Prevention'' initiative. Each
coalition was required to conduct a local community meeting on
out-of-wedlock births and submit a resolution from its local
elected body agreeing to attempt to reduce out-of-wedlock
birthrates in their communities. To highlight the initiative,
four regional forums on out-of-wedlock births were conducted by
the secretary of Health and Human Services and the
commissioners of Health and Social Services. More than $1
million in TANF funds were then distributed to 50 coalitions in
the more than 100 communities who positively responded.
(Virginia has 134 recognized city and county communities.)
These coalitions were promised that if Virginia was awarded one
of the $20 million prizes that Congress offered to five states
with the best results, the funds would flow through to those
communities who similarly showed the greatest decrease in out-
of-wedlock births without a concomitant increase in local
abortion rates. A majority of the coalitions chose to focus on
teen pregnancy prevention, and were given broad leeway to
design their own local, grass-roots initiative to help to solve
this difficult social problem. The Partners in Prevention (PIP)
initiative did not operate in FY 1999, but will operate again
in FY 2000, with potential awards reduced to a maximum of
$15,000 per coalition. The new PIP guidelines will also require
a focus on 20-30 year olds with an abstinence-only emphasis in
the approved interventions. Those funds are scheduled to be
awarded in August. Despite the 13-month lull in support for the
PIP coalitions, Virginia ranked 12th in its last review of
comparative state out-of-wedlock rates. Virginia is now working
with local and state social service leaders to assess the
potential use of excess TANF funds for preventive approaches to
youth development and teen pregnancy prevention and is hopeful
of assisting communities to replicate successful and
effectively evaluated models of youth development programs in
several areas of Virginia with these funds.
Abstinence Education. When Virginia received the initial
federal funds for abstinence education, the first year's
initiative involved a statewide media campaign to reduce sexual
activity before marriage. The ``Not Me Not Now'' media campaign
from Monroe County, New York, was secured through a contract
with its founders. Posters and television and radio spots were
targeted during prime time when adolescents were expected to be
tuned in. In the second year, six local community programs were
funded through a competitive proposal process. An evaluation
system was established to measure the effects of the programs,
since this type of intervention has not previously been tested
with adequate sample sizes, control groups, or satisfactory
evaluative methodologies. The programs are primarily serving
youths between the ages of 13 and 17. The programs begin their
second year of development in September.
Washington
Teen Pregnancy Prevention. The Workfirst program has
designed flyers and posters focusing on birth control and
family planning messages. Each community service office
provides family planning information and services. In most
offices a family planning worker and/or a public health nurse
is stationed on site to provide pregnancy prevention services
and information.
Abstinence Education. The Department of Health is currently
receiving funds for abstinence education. These funds have been
used for seven community-based projects around the state. These
projects focus on abstinence and public education. The
Department of Health and the Office of Superintendent of Public
Instruction have an interagency agreement to provide the ``Teen
Aware'' program that focuses on abstinence and waiting until
marriage.
West Virginia
Teen Pregnancy Prevention/Out-of-Wedlock Birth Reduction.
West Virginia, using Title V funds, supports a community-based
initiative to educate, promote, and support communities in
developing programs focusing on parent-child communication/
interaction; adolescent risk reduction behaviors such as
alcohol and drug use, and abstaining or postponing sexual
intercourse. In addition, the state, in collaboration with the
Domestic Violence Coalition, developed and distributed a
booklet that addresses statutory rape, and includes strategies
for helping youths resist coercive sexual advances. Targeted
efforts to reduce teen pregnancies include the availability of
contraceptive care at 133 community-based sites throughout the
state; hiring an adolescent pregnancy prevention specialist to
work alongside medical, social, educational, and community
partners designing activities and programs that foster youth
resiliency; and discouraging early onset of sexual activity.
Abstinence Education. West Virginia has contracted with
community organizations for the teaching of abstinence-only
curricula that adhere to federal statutory requirements.
Activities and oversight for the Abstinence-Only Initiative are
directed with input from a statewide advisory body comprised of
educators, parents, faith-based organizations, and the health
care community.
Wisconsin
Abstinence Education. Wisconsin has established the
Wisconsin Abstinence Education Project (WAEP) which has funded
13 local abstinence-only education grants, given to programs
that meet certain criteria for promoting abstinence. WAEP is an
important part of Wisconsin's new adolescent pregnancy
prevention plan, Brighter Futures, which proposes a
comprehensive, community-based approach to pregnancy prevention
and provides recommendations and strategies for a variety of
groups, including parents, educators, local officials, youths,
faith-based organizations, and the health care community.
Wyoming
Teen Pregnancy/Abstinence Education. TANF and abstinence
education funds are combined into an abstinence-only media
campaign called Sex Can Wait Wyoming. This TV and radio
campaign is aimed primarily at 9 to 14 year olds and
secondarily at their parents, siblings, and community. It
features a hotline that people can contact for more
information. This media program is based on Michigan's similar
program. Wyoming is also operating an ongoing task force
composed of state agencies, abstinence-based nonprofits, family
planning clinics, and family planning nonprofits. Funding is
primarily received from the TANF grant. The task force sponsors
an annual pregnancy prevention conference that explores issues
of unintended pregnancy. The task force has also granted money
to agencies wishing to expand pregnancy prevention services to
teens. Future plans are for initiatives to address male
involvement in the out-of-wedlock pregnancy issue.
State Contacts
----------------------------------------------------------------------------------------------------------------
State Department Name Phone
----------------------------------------------------------------------------------------------------------------
Alabama................................ Human Resources.......... Jean Blackman............ (334) 242-1978
Alaska................................. Health and Social Cheryl Adamson........... (907) 465-3382
Services.
Arizona................................ Economic Security........ Ben Levine............... (602) 542-0212
Arkansas............................... Bureau of Public Health.. Donnie Smith............. (501) 661-2243
California............................. Social Services.......... Chris Minnich............ (916) 654-1074
Colorado............................... Human Services........... Maynard Chapman.......... (303) 866-2054
Connecticut............................ Social Services.......... Zena Kovack.............. (860) 424-5334
Delaware............................... Public Health............ Prue Kobasa.............. (302) 739-4785
Washington, DC......................... Public Health............ Ellen M. Wells........... (202) 727-5930
Florida................................ Health................... Bridgett Rahim-Williams.. (850) 922-1218
Georgia................................ Adolescent Health........ Ronnie S. Jenkins........ (404) 657-2868
Guam................................... Public Health............ Lucy S. Cruz............. (671) 735-7104
Hawaii................................. Human Services........... Patricia Murakami........ (808) 586-5230
Idaho.................................. Health and Welfare....... Galen Louis.............. (208) 334-5957
Illinois............................... Family Health............ Sue Haury................ (217) 782-2736
Indiana................................ Health................... Judith Ganser............ (317) 233-1240
Iowa................................... Human Services........... Jo Lerberg............... (515) 281-4207
Kansas................................. Social and Rehabilitation Connie Ulmer............. (785) 296-2465
Services.
Kentucky............................... Public Health............ James S. Davis........... (520) 564-4830
Louisiana.............................. Social Services.......... Elaine Fontenot.......... (225) 342-0485
Maine.................................. Human Services........... Nancy Birkhimer.......... (207) 287-5361
Maryland............................... Human Resources.......... Stacy L. Rodgers......... (410) 767-7393
Massachusetts.......................... Health and Human Services Mary Osterman............ (617) 727-7600
Michigan............................... Community Health......... Virginia Harmon.......... (517) 335-9371
Minnesota.............................. Human Services........... Pam Reinstatler.......... (651) 296-9407
Mississippi............................ Human Services........... Rebecca Doyle............ (601) 359-4437
Missouri............................... Health................... Becky Houf............... (573) 751-9488
Montana................................ Public Health and Human Suzanne Nybo............. (406) 444-3775
Services.
Nebraska............................... Economic Assistance...... Dan Cillessen............ (404) 471-9270
Nevada................................. Human Resources.......... Vicki Kemp............... (775) 687-4715
New Hampshire.......................... Community and Public Joan Ascheim............. (603) 271-4516
Health.
New Jersey............................. Human Services........... Edward Tetelman.......... (609) 292-1617
New Mexico............................. Human Services........... Barbara Otto............. (505) 841-2973
New York............................... Health................... Barbara McTague.......... (518) 474-3368
North Carolina......................... Public Health and Human Sydney Atkinson.......... (919) 733-7791
Services.
North Dakota........................... Human Services........... Kevin Iverson............ (701) 328-2332
Ohio................................... Human Services........... Joel Raab................ (614) 466-1822
Oklahoma............................... Health................... Marilyn Lanphier......... (405) 271-4471
Oregon................................. Human Resources.......... Jeff Stell............... (503) 945-6737
Pennsylvania........................... Public Welfare........... Gail Bean................ (717) 772-7829
Rhode Island........................... Children, Youth and Pamela Goodwin........... (401) 462-2423
Families.
South Carolina......................... Social Services.......... Carol Singletary......... (803) 898-9376
South Dakota........................... Social Services.......... Donna Keeler............. (605) 773-4678
Tennessee.............................. Human Services........... Wanda Moore.............. (615) 313-4866
Texas.................................. Health................... Jack Baum................ (512) 458-7700
Utah................................... Workforce Services....... Shannon Bond............. (801) 468-0129
Vermont................................ Human Services........... Cheryl Mitchell.......... (802) 241-2244
Virginia............................... Social Services.......... Forrest Mercer........... (804) 692-1297
Virgin Islands......................... Human Services........... Lennox Zamore............ (340) 774-4673
Washington............................. Social and Health Rachael Langen........... (360) 413-3209
Services.
West Virginia.......................... Health and Human Services Pat Moss................. (304) 558-5388
Wisconsin.............................. Health and Family Joe Leean................ (608) 266-7882
Services.
Wyoming................................ Health................... Phyllis Sherard.......... (307) 777-7942
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Chairman Johnson of Connecticut. Thank you for your
testimony, all of you. It is very, very impressive to me that
the flexibility under TANF and the generosity of the funding is
allowing us to begin to look at some of the causes of our
problems rather than just the effects. I hope you will all be
part of, without exception, standing up for a continued level
funding of TANF because I think we are just now getting to the
payoff of flexibility in funding, and if we don't stick with
it, we will never get to solve some of the problems like
nonmarital births but also the difficult problems of substance
dependence and mental--untreated mental health problems and
things like that.
In fact, I think some of these programs that are aimed at
discouraging teenagers from getting into inappropriate
relationships will also get them into appropriate mental health
relationships that are very important. When I hear these kids
talk about their lives, honestly, the challenge to many of them
is far greater than most of us have ever faced.
So I think we do need to really fight for the TANF dollars
to be maintained because they--and it was very impressive, the
number and variety of State approaches that we see out there.
It also is interesting that, Ms. Miller--let me see now, Ms.
Maynard, the variety of things that you are evaluating and the
different approaches. So it will be useful to us to see both of
your reports as they get completed.
In doing that oversight work, Ms. Maynard, is it difficult
to determine whether or not programs are complying with the
letter of the abstinence law? You ran into this problem that we
have talked about in preceding panels of sort of gray area of
being serious about abstinence but also providing some
information about contraceptives.
Ms. Maynard. We have gone about our work in a fairly
strategic way. We have done a lot of homework before we have
gone to the field, before we actually select our final set of
sites for the evaluation. We are spending time in each site. We
are actually observing programs, reviewing materials, spending
a lot of time with the program staff. So we will be evaluating
programs that are totally consistent with the legislation. We
have not found it very difficult to determine what the messages
in the programs are.
Chairman Johnson of Connecticut. Would you say--what
percentage of these programs would you say do include some
information ultimately about safe sex?
Ms. Maynard. Well, we have not surveyed all of the programs
so, we have, as I said, gone about our work in a strategic way.
I can say that most of the abstinence education programs that
we have observed do address at some level issues of
contraception, but they do not address them in a promotional
way. They address them in a factual, informational way. It is
not a major piece of the intervention.
Chairman Johnson of Connecticut. Interesting. Would any of
the rest of you have any comment on that? Mr. Tetelman, from
sort of the practical point of your experience in New Jersey?
Mr. Tetelman. Our programs always have balance in them. We
don't have--the Department of Human Services isn't running the
abstinence only grant in New Jersey. That is being done through
the Department of Health and Senior Services, but what we have
learned is that if you offer young people a balance and a
connection with an adult to say, first, ``Look, the only safe
way is not to have sex at all but if you are going to have sex
then you need to protect yourself, you have to have knowledge
about it, and come talk to me''. You know, most of the time
when young people come talk to an adult they learn how to make
decisions because that is really what they are looking for in
many cases, how do I make a decision, I am getting pressure,
how do I actually come down to saying yes or no or is this
really what I want to do, and having that touch by that adult,
somebody they trust, we wish it were the parents more than it
is, but unfortunately, it is mostly staff in many of our sites,
makes a difference in young people obviously making the right
decision. Those statistics from the Pineline High School are
unbelievable.
Chairman Johnson of Connecticut. That was very impressive.
Mr. Tetelman. And it has been consistent for over 8 years.
It really was a drop and we have received a Dodge grant to try
to replicate it in some of our other sites, including our urban
sites.
Chairman Johnson of Connecticut. In that instance, do you
know much about whether the level of sexual activity dropped?
Did it drop among the early groups but later on actually, in
other words, it might not have dropped among the early groups,
the early groups might have just used contraceptives, but the
upcoming groups might actually have changed their behavior? Do
you have any----
Mr. Tetelman. It is all anecdotal, but I have actually
asked the same question of staff, and they say it is a real
mix, that some young people just make a decision, they get
their act together and say I have other things I want to do
with my life and I am not going to engage in sex. And other
ones say, ``Well, if I am going to engage, I am going to be
responsible about those activities.'' It is really mixed. We
don't have clean lines on it, but I think it is important to
offer--you know, we can't stick our heads in the sand and think
kids aren't going to have sex. They have sex, and if they are
going to have sex, we need to have a balance here to make sure
that they get the right information and protect themselves so
we don't have unwanted pregnancies.
Chairman Johnson of Connecticut. But certainly in those
programs, too, what is happening is that kids are getting a lot
of support to not have sex.
Mr. Tetelman. Absolutely, and the important thing is having
that connection with adults and having activities for young
people. I mean, we can talk about lots of different things, but
unless you have programs that kids can be involved in, whether
it is after school or jobs or things that keep them from free
time where they can get in trouble, that makes the biggest
difference.
Chairman Johnson of Connecticut. Anyone else have any
comment you want to make before we close? Yes, Ms. Miller.
Ms. Miller. I just want to say that one of the things we
have learned at the campaign is that the programs, as you say,
are very important, and they don't have to be focused
necessarily on pregnancy prevention or on sex ed or on
abstinence or on contraception. They have to include a
consistent, caring adult, skill building or opportunities to
excel, and they have to go on long enough to make a difference
in the lives of the young people.
Chairman Johnson of Connecticut. That certainly is what
Pathways/Senderos has found in our area, that the whole issue
really is trust and consistency and being there and that the
longer they are, the more the issue of contraceptive knowledge
is far from central. It is just an aside, but it does--the
questions do come up partly because they need that information
to counter their peers.
Thank you very much, all of you who have testified today.
We do appreciate your input, and I also think one of the wise
things about the Welfare Reform bill was that it did take some
different approaches that has enabled us to get this
conversation out in the open where our kids can benefit more
from it, and hopefully, we can benefit more from it, and as Ms.
Ware said, stop sending quite such contradictory messages to
our own children. Thank you very much.
[Whereupon, at 12:15 p.m., the hearing was adjourned.]
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