Teenage Wasteland

There is good news and bad news concerning teenage pregnancy. The good news is that the teen pregnancy rate has dropped steadily over the past 20 years nationally, across New York State, and in the Buffalo area. The bad news is that the teen pregnancy rate remains higher in the United States than all other developed countries, and the rate in Buffalo is still much higher than statewide or nationally. According to the Erie County Health Department, the teen pregnancy rate for Buffalo has dropped from 94.3 per 1,000 females ages 15-19 in 2009 to 58.7 per 1,000 in 2015, yet that is about twice the statewide and national rates.

Now the worse news. According to an article printed in The Buffalo News on August 16, 2017: "Program that has reduced teen pregnancies in Buffalo will lose federal funding next year" by Jane Kwiatkowski Radlich, more than 80 organizations throughout the country will lose funding through the Teen Pregnancy Prevention program, an effort passed during the Obama administration that was intended to last at least until 2020. However, the Office of Adolescent Health, within the Department of Health and Human Services, headed now by Donald Trump supporter and former Georgia Congressman Tom Price, has decided to terminate all funding by June 30, 2018. This program includes HOPE Buffalo, a joint effort of the Erie County Health Department and a New York City-based nonprofit organization, Cicatelli Associates Inc.

Stan Martin, the Director of Hope Buffalo stated that the organization's goal is "to reduce pregnancies among girls aged 15 to 19 by 30% by 2020 by focusing its work in nine ZIP codes in poor neighborhoods where the rates are highest. It is currently entering its third year of a five-year plan designed to provide info to 15,000 schoolchildren through a net-work of school, community-based and health care providers." Martin adds: "The rates are at an all-time low. The lowest they have been in years. I fear rates will start going back up (because the funding will end)."

So why is this seemingly vital funding coming to a premature end? The Department of Health and Human Services announced that it was eliminating funding for the Teen Pregnancy Prevention program due to "very weak evidence of positive impact of these programs." That is a blatantly inaccurate statement because it is impossible to assess the impact of these programs yet because they just began two years ago and teen pregnancy rates are not even available yet for 2016 let alone this year. As Stan Martin stated, HOPE Buffalo has yet to begin the 3rd year of a five year program. How can any assessment be made of a program's efficacy when it is only 40% complete?

Martin himself theorized that the Department of Health and Human Services under President Trump and Secretary Price is "emphasizing sex abstinence education over teen pregnancy prevention" despite numerous studies that have shown that a comprehensive sex education program that includes the risks and benefits of contraception to prevent pregnancies and sexually transmitted diseases is more effective than abstinence-only programs simply because not every teenager is going to abstain from sex. This appears to be yet another disturbing example of the Trump administration choosing ideology over scientific fact as well as eliminating a program that has the potential for much benefit because the Obama administration implemented it. The spitefulness of the current administration is truly egregious and causing great harm to many citizens.

Teen pregnancy is a topic for which I have immense interest. As a family medicine resident, the very first delivery I performed was that of a 16-year-old girl who was 22 weeks pregnant, ignorantly and recklessly went on an amusement park ride, suffered a traumatic rupture of her placental membranes and developed an infection that caused her to go into early labor. Since the fetus was too premature to survive and the mother's health was in jeopardy, there was nothing to do except let the natural process play out and deliver the fetus, which died about an hour later. I saw several teen mothers in the obstetrics clinic who did not have the means, either financially or mentally, to provide for their newborns and thus, the babies were malnourished. I know from personal experience that teens generally lack the maturity, both intellectually and emotionally, to serve as effective parents. Indeed, that is a primary focus of my attention in public health advocacy and I write about it extensively in my book The Lost Son: A Rock 'n' Roll Road to Redemption." Morality aside I see teen pregnancy and the broader issue of out-of-wedlock births to be a major public health and economic problem in the United States.

Here are a few passages from my book that illustrate both my knowledge and passion for combating this massive dilemma:

While the rate of children raised out of wedlock is highest among impoverished African-American and Hispanic women, a fact I witnessed firsthand as a medical intern, in the past 40 years the unwed birth rate has soared among all demographic groups, regardless of race, socioeconomic status, or even religion. Since the mid-1990s, over one-third of all American babies have been born to single moms. Whether or not the mother has the wherewithal to provide all that a child needs to be raised adequately in an ever-more complex society, there’s much evidence that a stable, two-parent household is a far better environment for the raising of a child. Numerous studies have shown that children who grow up without their biological father present are much more likely to live in poverty, abuse drugs and alcohol, drop out of school, commit crime/be imprisoned, attempt suicide and become pregnant/impregnate their girlfriend as a teenager than kids living with their married parents.

I taught various science courses at a small community college in Buffalo. Most of my students were female and training to become nurses or massage therapists. Many students were also single moms trying to make better lives for themselves and their children. However, it was obvious that many of the single moms struggled with their schoolwork in comparison to students who did not have children because the single moms had to spend so much time caring for their kids that they had less time for or were distracted while doing their homework assignments and studying for tests. Some single mothers could not handle all their combined personal and academic responsibilities and dropped out, while those that were able to graduate and go on to find jobs in their field always had a tougher road to travel, and it doesn’t have to be like that.

Teenage pregnancies and children raised by single parents is not just a major public health issue, but also a national economic problem. After World War II, the United States was the leading industrial/manufacturing giant on the planet. Back then there were plenty of good-paying, relatively low-skilled jobs for Americans lacking a college education. However, starting in the 1960s and increasing exponentially since the 1990s, globalization, “free trade” agreements and the greed of multi-national corporations has resulted in the widespread outsourcing of these jobs to other nations where labor is cheaper, governmental rules concerning employee health and safety are lax, and environmental regulations are far less stringent than in the U.S. The result is that high school dropouts and even high school graduates are typically sentenced to a lifetime of low-paying jobs and public assistance. It is more important than ever for American youths to obtain a college degree or at least some type of vocational training beyond high school in order to avoid economic misery and find solid employment in an economy that is becoming ever-more service-related, professional and technology-based, where advanced knowledge and/or complex, learned skill sets are a necessity.

For the sake of America's teenagers, HOPE Buffalo and the dozens of other organizations that rely on federal funding for their Teen Pregnancy Prevention programs, I sincerely hope that Congress, led by Democrats and perhaps some fair-minded, moderate Republicans that place scientific evidence and sound public health principles over ideology, will convince Trump and Price to back off on their partisan budget priorities and restore funding to these much needed educational interventions. Otherwise, it is ironic but not at all surprising that a president who was elected to his office on the basis of his business "skills" will contribute to reversing a trend that actually has a positive effect on the economy by better preparing teenagers for the workforce through avoidance of unwanted pregnancies and the many consequences of raising a child prior to finishing one's education and too often in the absence of the child's father.

#teenagepregnancy #Buffalo #OfficeofAdolescentHealth #DepartmentofHealthandHumanServices #PresidentTrump #TomPrice #ErieCountyHealthDepartment #sexabstinence #contraception #ideology #TheLostSon #Congress

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© 2017 by Peter McNeela.