California’s teen pregnancy rate declined by 52 percent between 1992 and 2005, the steepest drop registered by any state over that period—and far above the national decline of 37 percent. Public health experts credit this record decline to California’s aggressive and evidence-based teen pregnancy prevention efforts dating back to the 1990s, according to Winning Campaign: California’s Concerted Effort to Reduce Its Teen Pregnancy Rate, published in the Spring 2010 issue of Guttmacher Policy Review.

 

“California has made teen pregnancy prevention a high public policy priority, with a strong emphasis on providing teens comprehensive sex education and the health care services and counseling they need to prevent pregnancy,” says Heather Boonstra, author of the new analysis. “Above all, California’s success demonstrates that policies matter—both in allotting the necessary resources and in ensuring that the right types of information and services are available.”

 

Boonstra says a concerted effort in several key policy areas was at the core of California’s success:

 

• Comprehensive sexuality education: California is the only state that never accepted federal abstinence-only dollars under the rigid Title V abstinence-only-until-marriage program. The state ended its own experiment with ineffective abstinence-only education in the mid-1990s and subsequently shifted its resources to evidence-based, comprehensive sex education programs. A 2003 law consolidated and coordinated state policies on sex and HIV/AIDS education, requiring that any school-based sex education programs be medically accurate, age-appropriate and comprehensive.

• Contraceptive services: In 1997, California launched the so-called Family PACT program, which has four central features particularly well suited to address the needs of adolescents: Teens can enroll in the program if their own income meets the eligibility level and can access services confidentially; on-site enrollment allows clients to both enroll and receive services on the same day; the program increases access to services by including private physicians in addition to family planning centers; and it provides services to all low-income teens, regardless of their immigration status. According to a 2006 Guttmacher Institute analysis, California ranked first among states in overall efforts to help women—including teens—avoid unintended pregnancy.
• Private-sector involvement: Private foundations have played an important role in the state’s teen pregnancy prevention efforts. Several large foundations, including The California Wellness Foundation, have provided significant grants for research, public education and policy advocacy programs, community outreach and professional development. One of the foundation’s major legacies is the “hot spot” analysis, which guides resources to high teen birthrate regions.
• A long-term, bipartisan effort: Remarkably, California’s ongoing, statewide effort has spanned the administrations of three governors—two Republicans and one Democrat. This bipartisan support has been crucial to implementing a successful, long-term strategy based on sound science rather than making teen pregnancy prevention a political football.

 

“In California, the whole of the effort clearly added up to more than the sum of the parts,” Boonstra says. “However, past success does not automatically translate into future results, and California’s progress could be as fragile as it has been remarkable. The current economic recession and chronic state budget crises have put teen pregnancy prevention programs in jeopardy and present significant future challenges. It would be truly tragic for California to put at risk the hard-won gains of the past two decades.” Related research on the most recent trends in U.S. teen pregnancy rates the U.S. teen pregnancy rate increased among all ethnic and racial groups between 2005 and 2006.

 

Earlier research had documented that the significant drop in U.S. teen pregnancy rates in the 1990s was overwhelmingly the result of more and better use of contraceptives among sexually active teens. However, this decline started to stall out in the early 2000s, at the same time that abstinence-only programs were becoming more widespread, teens were receiving less information about contraception in schools, and their use of contraceptives was declining.

 

Click here for Winning Campaign: California’s Concerted Effort to Reduce Its Teen Pregnancy Rate by Heather D. Boonstra.

 

The Guttmacher Policy Review analyzes reproductive health policy in Washington, DC and state capitals across the country—providing the information critical to understanding, anticipating and effecting change.

The Guttmacher Institute works to advance sexual and reproductive health in the United States and worldwide through an interrelated program of social science research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate, promote sound policy and program development, and, ultimately, inform individual decision making.