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HHS directly funds teen pregnancy prevention programs in nearly 2,234 communities -- about 47 percent of all communities across the country. HHS provides significant funding for abstinence education and other programs to prevent teen pregnancy and disease. In addition, HHS funds a wide range of health and human services programs through state block grants, including those that provide health and social services to teenagers that further pregnancy prevention goals. HHS is committed to building public-private partnerships, improving research, evaluation and data collection, and disseminating information on innovative and effective practices.

BACKGROUND

After rising steadily from 1987 to 1991, the birthrate for teens aged 15-19 declined for 10 straight years, from a high of 62.1 per 1,000 teens aged 15-19 in 1991 to a record low of 45.9 in 2001, according to preliminary figures. The birthrate for young teenagers aged 15-17 fell 8 percent from 2000 to 2001, reaching 25.3 births per 1,000 teenagers. All 50 states had a decline in their teen birthrates between 1991 and 2000, with 10 states recording declines of more than 20 percent during this period. Recent declines in both birth and abortion rates indicate that teen pregnancy rates are continuing to fall. Overall teen pregnancy rates have dropped 19 percent since 1991. About 900,000 pregnancies occur each year among American teenagers aged 15-19. Most of these pregnancies are unintended. Almost 190,000 teens aged 17 and younger have children. Their babies are often of low birthweight and have disproportionately high infant mortality rates. They are also far more likely to be poor.

HHS PROGRAMS TO PREVENT TEEN PREGNANCY

The department's major teen pregnancy prevention initiatives promote the postponement of sexual activity as the most effective way for adolescents to prevent teenage pregnancy and sexually transmitted diseases, including HIV infection.

Abstinence Education Program. The welfare reform law enacted in 1996 created the Abstinence Education Program, which provides federal grants to states for abstinence education activities such as mentoring and counseling designed to promote abstinence from sexual activity until marriage. The law provided an annual appropriation of $50 million for each fiscal year from 1998 through 2002. HHS' Health Resources and Services Administration (HRSA) administers this program. The welfare reform law also gave states the flexibility to use additional federal funds for teen pregnancy prevention activities. The President's fiscal year 2003 budget continues funding for this program at $50 million. More information is available at mchb.hrsa.gov/programs/adolescents/abstinence.htm.

Grants for community-based abstinence education. In 2001, HRSA provided the first federal grants in a new initiative to support community-based abstinence education programs involving public and private entities. The grants support the development and implementation of abstinence-only education programs for adolescents, ages 12 through 18, through special projects of regional or national significance. HRSA received $20 million for fiscal year 2001 to begin this new grant program and $40 million for fiscal year 2002. The President's 2003 budget provides $73 million for this program, an increase of $33 million over fiscal year 2002. More information is available at mchb.hrsa.gov/programs/adolescents/abstinence.htm.

Adolescent Family Life Program. Through this program, HHS funds prevention demonstration projects to develop and test abstinence-based programs designed to delay the onset of sexual activity, and prevent adolescent pregnancies, sexually transmitted diseases and HIV/AIDS. The program also supports care demonstrations that provide comprehensive health, education, and social services to pregnant and parenting adolescents, their children, family members and young fathers, and research into the causes and consequences of adolescent pregnancy. In fiscal year 2001, the program supported 73 abstinence education projects and 37 care projects. Since it was created in 1981 under Title XX of the Public Health Service Act, the program has supported more than 300 care and prevention demonstrations and 68 research projects - most of which include abstinence education activities. HHS' Office of Population Affairs (OPA) administers the program, for which the President has budgeted $31 million for fiscal year 2003, of which $12 million is for activities focused on abstinence. More information is available at opa.osophs.dhhs.gov/titlexx/oapp.html.

Community coalition prevention demonstrations. Since 1995, the Centers for Disease Control and Prevention (CDC) has funded demonstrations for the prevention of teen pregnancies. These projects support coalitions of local, public and private agencies, and organizations in communities with high rates of teen pregnancy in order to develop community action plans, coordinate efforts to reduce teen pregnancy, identify gaps in current programs and services, target existing resources, and design evaluation plans. For fiscal year 2003, President Bush's budget includes $8.7 million to help community coalition partnerships implement their plans and to support related data collection, evaluation and education activities.

Working with boys and young men. HHS programs work to ensure that men, including preteen and teenage boys, receive the education and support necessary to postpone fatherhood until they are emotionally and financially capable of supporting children. Boys and young men are encouraged to prevent premature fatherhood through such programs as the abstinence education programs, the Adolescent Family Life program, the adolescent male family planning initiative, and the Partners for Fragile Families demonstration program.

School-based prevention work group. The CDC is working with eight national organizations to explore and strengthen the role that state and local education and health policymakers can play in preventing teen pregnancy. The Joint Workgroup on School-based Teen Pregnancy Prevention (JWG) has developed a plan to help constituents develop and implement prevention policies and programs. The JWG provides on-site, customized technical assistance through two-day training sessions.

OTHER HHS PROGRAMS

In addition to the programs that target teen pregnancy prevention directly, HHS funds many large health and social service programs that have teen pregnancy prevention components. These programs include:

• Through the Title X family planning program and the Medicaid program, many teens receive family planning and reproductive health services. These services may include counseling and education. OPA administers the Title X program and the Centers for Medicare & Medicaid Services (CMS) administers Medicaid.

• HHS supports general adolescent health care, both through block grant programs such as the State Children's Health Insurance Program (SCHIP) and the Maternal and Child Health Services Block Grant (Title V), and by providing funds directly to countless community clinics, including those that serve migrant workers and Native Americans. Most physicians and health care providers consider pregnancy prevention a primary objective for their adolescent patients.

• HHS agencies provide education, health and social services to runaway and homeless youth, as well as those at risk of substance abuse or in need of substance abuse treatment. Studies show that teens engaged in these risky behaviors are at higher risk for fathering or bearing children. These programs can help reduce teen pregnancies directly through prevention education or indirectly by addressing underlying health and social issues that increase the risks of unintended pregnancy.

LINKS TO MORE INFORMATION

The National Center for Health Statistics maintains data on national and state teen birthrates and related information, including "Births: Preliminary Data for 2001" and "Births to Teenagers in the United States, 1940-2000" at www.cdc.gov/nchs/births.htm.

The CDC's Youth Risk Behavior Surveillance System provides data on state and national trends on sexual activity and other behavior that poses health risks among high-school students at www.cdc.gov/nccdphp/dash/yrbs/index.htm. The CDC also provides information about teen pregnancy and other adolescent health issues at www.cdc.gov/health/adolescent.htm.

The National Institute of Child Health and Human Development funds the National Longitudinal Study of Adolescent Health on the health-related behaviors of adolescents in grades 7-12. Information on the study is available at www.cpc.unc.edu/addhealth.

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