Recently, the U.S. Department of Health and Human Services (HHS) abruptly cut short grants for the Teen Pregnancy Prevention (TPP) Program. These cuts will affect more than 80 institutions and organizations that reach some of the most at-risk youth across the country.
These cuts came during year three of the five-year grants, when HHS chose to circumvent Congress by notifying grantees that their funding would end. This took place even before Congress began work on the fiscal year 2018 appropriations process, an unprecedented action that will be devastating to the communities that grantees serve.
As a result of these cuts, vulnerable youth will lose access to the education they need and would have received if grants were continued. The TPP Program has long been a benchmark of evidence-based work, which supports replication of effective programs as well as investing in innovation and evaluation to continue expanding knowledge about what works and for whom. Cutting off these projects mid-stream means abandoning evaluations that would yield critical knowledge for reaching at-risk populations, including system-involved youth.
Since the federal government began investing in evidence-based approaches to teen pregnancy prevention in 2010, declines in teen births have accelerated. In fact, the teen birth rate declined by 41 percent from 2010 to 2016 — a drop more than twice as large as the decline in any other six-year period.
However, there are still disparities in teen pregnancy rates. Nearly half (48 percent) of teen girls in foster care had ever been pregnant by age 19, compared to 27 percent of teen girls more broadly. In fact, teens in foster care are nearly twice as likely to have had sex and (among girls), one-third more likely to not use any contraception. This is particularly alarming because 17 percent of foster youth report their first intercourse occurring between the ages of 10-12. Meeting the unique sexual health needs of youth in foster care can be a daunting task, but many TPP grantees specifically work with this cohort of young people.
West Virginia has the sixth highest teen pregnancy rate in the country. Mission West Virginia, one of 84 TPP Program grantees, has implemented evidence-based programs for youth age 10-19 who live in high-need communities across 19 counties in rural West Virginia Appalachia. This grant focuses on reaching those most at risk through three juvenile justice centers, four foster care facilities, six alternative schools, 45 middle schools, and 43 high schools.
System-involved youth (whether in foster care or the juvenile justice system) already face many challenges such as sexual trauma, lack of a positive or healthy adult support system, placement and school stability, and achieving transitioning into a safe permanent home. TPP grantees help teach these vulnerable youth about healthy relationships, communication, prevention of pregnancy and sexually transmitted infections (STIs), and their rights to sexual and reproductive health services.
Many of the models funded through the TPP Program have also been proven to reduce the number of teen pregnancies or related behaviors like delaying sex, increasing contraceptive use, and decreasing the number of sexual partners: 41 evaluations conducted during the first round of grants found 12 evaluations (29 percent or 1 in 3) showed positive impacts. This is well above the 10 to 20 percent of randomized control trials that experts say typically demonstrate positive results. When compared to what is typically expected, the TPP Program did very well, exceeding the expectations evidence experts typically have for randomized control trials in social programs. In fact, of the conclusive studies conducted, 43 percent were found to have positive impacts. In addition, the TPP Program is supporting the development and evaluation of innovative approaches to meet the needs of system-involved youth.
Although there have been historic declines in teen pregnancy, it is vital to continue to address the disparities that persist. The United States has the highest teen pregnancy rate of any industrialized country in the world. Nearly one in four girls in the U.S. still become pregnant at least once by the age of 20, and rates are significantly higher for young women of color and those living in poverty.
In addition, The National Campaign conducted polling showing that 85 percent of adults favor continuing the TPP Program, including 75 percent of Republicans and 89 percent of Democrats. Dismantling this evidence-based program will harm hundreds of thousands of our most vulnerable youth by denying them high-quality information and education that would help them make healthy decisions about their futures.
With such high stakes for our most at-risk youth, why would our government suddenly decide against investing in our nation’s youth by defunding programs like the TPP Program? These are questions that Congress is now asking HHS. If you care about these issues, we urge you to reach out to your members of Congress and share your support for continuing the Teen Pregnancy Prevention Program.