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New Study confirms: The government must stop funding abstinence-only programs

By Lexie Wille, Research Fellow

Since 1981, the United States government has spent over $2.2 billion in federal funds on abstinence-only programs. And for years, advocates have been exhorting the need for the U.S. federal government to prioritize funding for evidence-based adolescent sexual health programs rather than continuing to pour millions of taxpayer dollars into ideologically-driven abstinence-only programs. This year, a new study looked more closely at how federal funding and political ideology interact to impact the sexual health of young people. The results are stunning and further the fact that, despite being supported by billions in federal dollars, abstinence-only programs continue to fail American youth.

What is this study all about?

The study, Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention: Does State Ideology Affect Outcomes? (written by Ashley Fox, PhD, Georgia Himmelstein, BA, Hina Khalid, PhD, MPP, and Elizabeth A. Howell, MD, MPP) utilized SIECUS State Profile data to help determine two major findings:

  1. Abstinence-only programs are ineffective at achieving their own stated goals–and their impacts are especially adverse in conservative states.
  2. The type of program funding that conservative states receive — abstinence-only or pregnancy prevention — has a statistically significant impact on the state’s teen birth rate.

While no young person should ever be shamed or stigmatized for becoming a parent, the United States’ historical focus on teen pregnancy outcomes has produced robust data points worthy of analysis. The authors of this study used existing data to investigate the relationship between various states’ allotted abstinence-only and pregnancy- prevention funding and their effect on adolescent birth rates within those states over time.

  • Abstinence-only funds go toward programs that teach total abstinence from sex until marriage as the only acceptable option for adolescents and teenagers. They generally do not cover contraceptive methods or condoms, except to emphasize failure rates. 
  • Pregnancy-prevention funding goes towards sexual health and education programs that teach students about abstinence in addition to concepts like birth control, condoms, and how to have safer sex.

To look at the relationship between these variables, the researchers used data from the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute to calculate the number of adolescent births — babies born to mothers between ages 15 and 19 — in each state per year. 

Then they used SIECUS State Profile reports from 2003-2010 to help gather the amounts of abstinence-only federal funding by state. From there, the researchers calculated a number they called the per pupil expenditure amount by dividing the total dollars spent on each type of funding by the total number of high school students in the state (and adjusted for inflation). 

Finally, the researchers categorized each state’s overall political and religious ideology as either conservative or liberal using previous studies’ “validated measures of state government and citizen ideology” and controlled for other factors that can affect birth rates including: state abortion rates and policies, state poverty rates, state demographic information, and state unemployment rates.

The researchers guessed that abstinence-only funding would be more effective at reducing adolescent births in conservative states, where the ideology motivating the policy would be more likely to resonate with the population. 

The researchers guessed wrong.

So, what did the researchers find?

They found that for each dollar per student spent on abstinence-only funding within conservative states, there was actually an increase in the number of babies born to adolescent mothers within that state. Statistically, each dollar of abstinence-only funding spent per student in conservative states resulted in an average of 3 additional babies born to adolescent mothers out of every 10,000 babies born.

Further, they found that for each dollar per student spent on pregnancy-prevention funding in a conservative state, there was an even larger average decrease in the number of adolescent births compared to what was observed in more liberal states. In other words, when federal funding supports pregnancy-prevention programs, there are about 23 fewer babies born to adolescent mothers in conservative states out of every 10,000 births.

Why do these findings matter?

In other words, conservative states received significantly less funding for pregnancy prevention programs, but when those programs were funded, they had an out sized impact on reducing rates of teen pregnancy. 

Unfortunately, the massive skewing of out sized spending on abstinence-only programs, as compared to pregnancy-prevention programs, mutes the difference in impact. In 2008, conservative states received about $71 million in federal abstinence-only program funding, or about $4.52 per pupil. But in 2014, after the federal government began funding pregnancy-prevention programs, conservative states received only $14 million in funding, or about $0.80 per pupil. 

This huge difference in funding clouded researchers’ ability to compare the effects of the two programs. But when they looked more closely at the data coming from conservative states, the impact of program funding on birth rates became clear. If pregnancy-prevention and other sexual health promotion programs were funded at comparable rates to abstinence-only programs, their effect on adolescent birth rates, on a national scale, would be jaw-dropping.

Overall, the results of the authors’ analysis suggest that the funding of abstinence-only programs is not just ineffective, but also negatively impacts conservative states most. That’s because conservative states receive the highest amounts of abstinence-only funding in the U.S. and report the highest rates of adolescent births. The results also suggest a remarkably strong positive effect of pregnancy-prevention funding–confirming that these programs are significantly more successful at decreasing adolescent birth rates.

Most importantly, these findings suggest that young people living in conservatives states are the most affected by the amount of federal funding, and for which type of program, their state receives. This raises serious concerns about the Trump administration’s ongoing support–to the tune of $110 million more taxpayer dollars in 2019–for abstinence-only programs.

Ultimately, Fox et. al. add new evidence to support the expansive body of research proving that abstinence-only programs do not work. In reality, these programs can, and do, negatively impact the ability of young people to manage their own sexual and reproductive freedom. This underscores the importance of increasing federal funding for evidence-based adolescent sexual health programs that benefit teen sexual and reproductive health outcomes in the United States, and most especially in conservative states. The data could not have a clearer conclusion: the United States government must stop funding abstinence-only programs.