Trump Kills an Ineffective Obama-Era Program

The Trump administration has recommended defunding a $100 million-plus a-year Obama-era grant program designed to reduce teen pregnancy, to the screams of the liberal media. The program, created by Congress in 2010 during that brief and shining moment right after Barack Obama’s election when Democrats controlled both houses, was supposed to be “evidence-based”—that is to say, grounded in contraceptives promotion instead of postponing sex as had been the case with earlier federal teen pregnancy efforts. Indeed, the very word “abstinence”—derided as ineffective—was and still is a dirty word among the advocates of so-called “comprehensive” sex education that would supposedly put a damper on childbearing by unmarried adolescents.

But the Federalist’s Mollie Hemingway reported last week, the Teen Pregnancy Prevention program (abbreviated, confusingly, to TPP and part of a 2010 appropriations act), which hands out grants to public and private entities to provide “medically accurate and age appropriate” pregnancy-reduction programs for adolescents, hasn’t produced much in the way of results. “Evidence-based” meant that each of the programs was supposed to rigorously analyzed (including replications with different teen populations) for effectiveness, and a report duly issued. That report, covering about 40 percent of the programs financed by the nearly half a billion dollars that had been poured into TPP grants from FY 2010 through FY 2014, emerged from the Health and Human Services Department’s Office of Adolescent Health in 2016. As Hemingway wrote:

In some cases, the grant programs for reducing pregnancy actually showed increases in reported pregnancy and the likelihood of becoming pregnant. Even for some programs that showed short-term positive results, the improvements usually disappeared within a few months…. Only four of the more than 75 replications were found effective, and even then they were not found effective over time. Only eight of the 27 programs trying new approaches had even mildly positive results. Many of the programs weren’t even evaluated, with only 41 of the 102 grantees reporting results on effectiveness.

The grants, ranging in size from $500,000 to $10 million, went to states, cities, university health departments, school districts, and after-school programs run by such entities as Volunteers of America and Planned Parenthood, produced such results (summarized by Hemingway) as:

Latino teens offered the program after school had similar rates of sexual debut, contraceptive use at last sex encounter, and contraceptive use in the past three months relative to youth offered a fitness and nutrition program both immediately after and six months after the program ended.

And:

Women offered four weeks of access to [a TPP program at Tulane University] reported similar rates of reliable contraceptive use, pregnancy, and chlamydia or gonorrhea infection as women offered a nutrition and wellness program.

The media jumped all over HHS’s termination, mostly set to go into effect as of June 30, 2018, but in some cases immediately. Typical was the reaction of Los Angeles Times columnist Michael Hiltzik, who blamed it on a “gang of three extremists” on abortion and abstinence-only sex education appointed to key HHS positions soon after President Trump’s inauguration. (The ringleader of the gang is presumably Charmaine Yoest, a former president of Americans United for Life who is now assistant secretary for public affairs at HHS.)

But the only evidence that Hiltzik and other TPP defenders have come up with that TPP is actually effective is that it sure involves a lot of teenagers. Here’s Hiltzik:

“We’d been expecting that funding could be cut,” says Luanne Rohrbach of the Keck School of Medicine at USC, which is in the third year of a $10-million grant to provide educational outreach to as many as 20,000 teens in South Los Angeles and Compton who are at risk for unintended pregnancies. “But we didn’t think it would happen this way, and expected that there would be discussion about it. We thought there would be an opportunity at least for the program to be deliberated.”…

The program brings comprehensive sex education to students in middle schools in the L.A. Unified and Compton school districts, teaching them everything from anatomy to how to choose high-quality friendships, resist offers of sex if they’re not interested, and avoiding STDs through contraception. One part of the program is directed at the parents of at-risk children.

Hiltzik and others also point to the fact that teen pregnancy rates in the U.S. have declined steadily since 2010 (actually since 1991 give or take a few upticks, the last of which occurred in 2007)—although not, apparently in the South Los Angeles area served by the USC program with its $10 million in taxpayer dollars. There, the rate of live births to mothers age 15-19 remains at 51 out of every 1,000 live births, compared to 28 out of 1,000 in Los Angeles County overall. Perhaps six years’ worth of TPP programs is responsible for the downward trend—but it also might have to do with a well-documented general decline in fertility among women under 30 over the past quarter-century, a decline only partially offset by increased rates of childbearing among women over 30.

The federal government has been launching programs aimed at reducing teen pregnancy since 1981, when Congress created the Adolescent Family Life Program, which at least during GOP presidencies focused mostly on abstinence. After steady declines in appropriations (the last one, in FY 2011, was a mere $12 million), the program effectively shut down. There have also been assorted abstinence-focused block grants over the years. The Obamacare law and a series of related acts have directed about $75 million in federal dollars a year to a Personal Responsibility Education Program of grants to programs combining contraceptive education and the teaching of life skills.

Whether any of this money has actually resulted in a decline of births to unwed teenagers remains an open question. Low rates of pregnancy out of wedlock would seem to have more to do with social conditions—shame, early marriage, religious beliefs, peer pressure—than expensive federal programs. At least that’s what the “evidence” behind TPP seems to be pointing toward.

This post originally appeared on Weekly Standard

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