ADVOCATES FOR YOUTH

Executive Summary Trends in Teenage Pregnancy & Childbearing Methodology Estimates of Federal Expenditures Estimates of Federal Investments Conclusion & Recommendations Endnotes Appendix A: Percent Change in Teen Birth Rate Appendix B: Expenditures & Investments Cost Formulas Appendix C: Key Differences Between AFDC & TANF Order Information

Teenage Pregnancy, The Case for Prevention [PDF]

Methodology

A Historical Perspective

In 1986, Advocates for Youth began calculating single-year federal expenditures to support families in which the first birth occurred while the mother was a teenager. Advocates for Youth calculated these federal expenditures in order to highlight the public and societal costs of too-early childbearing. In 1993, some members of Congress used Advocates' figures to bolster their assertions that public assistance programs were too costly and should be eliminated. Such misguided arguments contributed to the establishment of a welfare reform policy which ignores the enormous costs—especially in health and education—incurred when the nation fails to assist young families and others in need. Advocates for Youth believes that the nation must both continue to support vulnerable young families and also make a corresponding financial investment in—and commitment to—preventing teenage pregnancy.

Therefore in 1998, in order to provide a context for federal expenditures to support young families, Advocates for Youth changed its methodology to additionally calculate the amount of money invested by the federal government in preventing teenage pregnancy. Advocates examines both expenditures and investments at the national level because the federal government is the largest funding source for prevention programs, sets national priorities by its funding decisions, and consistently supports the greatest number of prevention programs across the nation. Teenage Pregnancy, The Case for Prevention, also known as the "Cost Study," draws public attention to the need to invest more federal dollars in preventing teenage pregnancy in order to save federal expenditures to support future families.

The Cost Formula

In 1997, the Southern Regional Project on Infant Mortality, with the assistance of a Technical Advisory Group, updated the assumptions and revised Advocates' original cost formula. The Technical Advisory Group included other national experts as well as staff from Advocates for Youth. Revisions included the addition of data for costs of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and a more recent federal and state estimate on the percent of social service recipients who were teens at their first birth. The Technical Advisory Group determined that the appropriate national percentage of social service recipients whose families began with a birth to a teen is 47 percent. This percentage is derived from averaging the data from two reports—one by the U.S. General Accounting Office (GAO) and the other by the Urban Institute.^23,24 The Southern Regional Project on Infant Mortality used the new formula to calculate fiscal year 1995 public expenditures and investments—both state and federal funds—for 20 southern states and provides a state-by-state analysis of the findings.^{25 §}

In 1998, Advocates for Youth published Teenage Pregnancy: The Case for Prevention, calculating the federal investments in pregnancy prevention and comparing them to federal expenditures to support families begun with a birth to a teen. Once again, Advocates revised the cost formula.

A 1996 analysis of the Survey of Income and Program Participation (SIPP) by a private research firm indicates that 55 percent of social service recipients were teens at the birth of their first child.²⁶ Congressional documents use this figure.²⁷ Therefore, Advocates for Youth used 55 percent as the estimated percentage of social service recipients who were teens at the birth of their first child in calculating costs associated with all but one of the federal programs. Advocates applied the 55 percent calculation to Medicaid, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and Aid to Families with Dependent Children. However, Food Stamp Program recipient families are less likely to have begun with a birth to a teen. Therefore, Advocates for Youth's expenditures formula used 47 percent as the estimated percentage of Food Stamp Program recipients who were teens at the birth of their first child when calculating this federal program's expenditures.

Fiscal Year 1996

In this updated edition of Teenage Pregnancy, The Case for Prevention, Advocates for Youth examines the federal government's expenditures and investments related to adolescent pregnancy for the federal fiscal year 1996 (October 1, 1995 through September 30, 1996).

Estimating the annual expenditures and investments is not straightforward. Limited data exist to quantify the number of prevention and intervention programs that reach adolescents. Therefore, Advocates for Youth does not include programs for which information is not kept by age or childbearing status of recipients (such as Social Services Block Grant funds for family planning services). Moreover, no accurate picture exists of the individuals who use some programs, such job training, housing subsidies, subsidized school meals, special education, foster care, and day care programs. Therefore, Advocates excludes these programs from its analysis. Advocates for Youth's analysis of federal expenditures and investments includes only those federal programs that reach the greatest number of recipients. Moreover, the analysis is based on published data and estimates that have been provided by federal employees. It is, therefore, a conservative estimate of these costs.

After compiling the data for fiscal year 1996, Advocates for Youth calculated:

• Total federal expenditures^** to provide services and support to families which began with a birth to a teen, including families now headed by adult females who were teenagers when they had their first child

• Total federal investments^** in the prevention of teenage pregnancy among youth ages 15 to 19, including programs designed to prevent second (and higher order) pregnancies in teenage mothers. For programs serving a more generalized population, Advocates for Youth included only the percentage of their budgets that were dedicated to serving teens.

Four federal programs—Medicaid, Social Services Block Grant, Maternal and Child Health Services Block Grant, and the Adolescent Family Life Program—allocated funds both to provide services and support to families which began with a birth to a teen and to prevent teen pregnancy. Although 1.3 percent of Social Services Block Grant (SSBG) funds were used to provide family planning services in fiscal year 1996, Administration contacts could not estimate the percentage of family planning service recipients who were teens. Advocates for Youth, therefore, excluded the Social Services Block Grant from the investment calculation. The other three programs were included in both the expenditure and the investment calculations.

The expenditures formula includes federal costs associated with:

• Medicaid—Title XIX of the Social Security Act
• Aid to Families with Dependent Children (AFDC)—Title IV-A of the Social Security Act
• Food Stamp Program
• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
• Social Services Block Grant (SSBG)—Title XX of the Social Security Act
• Maternal and Child Health Services Block Grant—Title V of the Social Security Act
• Adolescent Family Life (AFL) Program—Title XX of the Public Health Service Act.

The investments formula includes federal costs associated with:

• Medicaid—Title XIX of the Social Security Act
• Healthy Schools, Healthy Communities (HSHC)
• Healthy People 2000 (Preventive Health and Health Services Block Grant)
• Community Health Center (CHC) Program
• Community Coalition Partnership Program for the Prevention of Teen Pregnancy (CCPPPTP)
• National Family Planning Program—Title X of the Public Health Service Act
• Maternal and Child Health Services Block Grant—Title V of the Social Security Act
• Adolescent Family Life (AFL) Program—Title XX of the Public Health Service Act.

Appendix B provides a more detailed explanation of the expenditures and investments cost formulas that Advocates for Youth used to calculate data for federal fiscal year 1996.

In fiscal year 1996, the federal government spent $38.0 billion to help families that began with a birth to a teenager, including families in which that teenager has since become an adult. At the same time, the federal government only invested $138.1 millionto help adolescents delay or prevent pregnancy.

This disparity reflects the federal government's lack of commitment to preventing teenage pregnancy. Despite the enormous potential savings to be reaped by reducing teenage pregnancy and childbirth, the United States invests far too little to prevent pregnancy among the nation's young people.

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^§ The methodology used for Expenditures and Investments: Adolescent Pregnancy in the South, Vol. II (1997) and the 1998 and 1999 editions of Advocates for Youth's Teenage Pregnancy, the Case for Prevention differs from methodologies used in Advocates' and the Project's previous publications. Estimates of expenditures and investments published before 1997, therefore, should not be compared with estimates published after 1997.

^** The terms, "expenditures" and "investments," are adapted from Expenditures and Investments: Adolescent Pregnancy in the South (1997).²⁵

Source/Citation:
Feijoo AN. Teenage Pregnancy, the Case for Prevention: An Updated Analysis of Recent Trends & Federal Expenditures Associated with Teenage Pregnancy. Washington, DC: Advocates for Youth, 1999.

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