Tag Archives: cdc

Policy Prescriptions to Prevent Teen Pregnancy

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Most teens would probably say they don’t want to become pregnant–in fact 87% of teen pregnancies in 2001 were reportedly unintended (see Figure 1). Even though there have been tens of thousands of teen pregnancies in recent years, teen births in the US have actually declined over the last 20 years, from 61.8 live births per 1,000 females aged 15-19 years in 1991 to 29.4 in 2012. This trend, which is due to factors that include teens making more informed decisions regarding their sexual health, is encouraging and suggests we can continue to make progress in preventing teen pregnancies.

First, we need to understand what makes teens more likely to get pregnant. Isabel Sawhill, Adam Thomas, and Emily Monea, in the Future of Children, outline several plausible explanations including cultural norms of increased acceptance of premarital sex and having children outside of marriage, a lack of positive alternatives to single motherhood, an attitude of fatalism, the high cost and limited availability of contraception, lack of knowledge about contraception and reproductive health, and inconsistent or incorrect use of contraception. The authors point out that these explanations generally fall into the categories of motivation, knowledge, and access.

Next, we can examine possible solutions. The Centers for Disease Control and Prevention recently released a Vital Signs brief outlining what the federal government, health care professionals, parents/caregivers, and teens can do to prevent teen pregnancy. What I like about the CDC’s suggestions is that they start where the teen is and show how adults can support teens’ healthy development. For example, professionals can encourage teens to delay sexual activity but should also encourage sexually active teens to consider the most effective methods of birth control. Parents can know where their teens are and what they are doing (isn’t there an app for that?), especially after school, and talk with their teens about sex.

Finally, are programs that promote these types of solutions worth the cost? Sawhill and colleagues, in their Future of Children article, conducted simulations of the costs and effects of policy initiatives that encouraged men to use condoms (motivation), discouraged teen sexual activity and educated participants about proper contraceptive use (knowledge), and expanding access to Medicaid-subsidized contraception (access). All three had good benefit-cost ratios, suggesting they are excellent social investments that can actually save taxpayer dollars. For more information on how to prevent teen pregnancy and unintended pregnancies in general, see the Fragile Families volume of Future of Children.

Higher Autism Rates: What Can Be done?

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The newest data on Autism Spectrum Disorder (ASD) from the Centers for Disease Control and Prevention (CDC) offer an alarming picture of childhood disability in America. Approximately 1 in 68 children who were 8 years old in the 11 participating states in 2010 were identified with ASD. This new estimate is more than twice as high as the earliest estimates from 2000 and 2002. The CDC states that “we don’t know what is causing this increase. Some of it may be due to the way children are identified, diagnosed, and served in their local communities, but exactly how much is unknown.”

People with ASD can have numerous strengths, but the challenges associated with ASD and other disabilities can be persistent and costly for individuals, families, and society. In the Future of Children issue on Children with Disabilities, Stabile and Allin calculated that the average annual cost (in 2011 dollars) to families of children with disabilities was approximately $10,800, and approximately $19,700 to social programs such as Medicaid and special education.

Even though there might be extra costs early on, Aron and Loprest note that early detection and intervention is crucial, and both sets of authors point out that early detection can provide long-term cost savings. However, some families are not screening their children due to barriers such as limited access and the belief that it’s unnecessary. Stabile and Allin emphasize that mental health problems, as opposed to physical disabilities, appear to be particularly associated with negative effects on future wellbeing in adulthood.

Having previously practiced social work in a treatment program for adults with ASD, ADHD, and learning disabilities, I’ve seen first-hand the difficulties that such adults can experience. These include difficulty developing and maintaining relationships (especially romantic relationships), finding and keeping gainful employment, and having healthy self-esteem after years of being bullied by peers.

With the increased prevalence of ASD among children, policy makers should remember that this is not simply a childhood disability, but a lifelong disorder with potentially significant long-term costs and challenges. Clearly, we need more research to understand the causes of ASD, but the funding and evaluation of expensive interventions to prevent and reduce the negative aspects associated with ASD, and other disabilities, during childhood and early adulthood might be justified given the research found in this Future of Children issue.