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  March 7, 2018

Trump Continues War on Science, Axes Teen Pregnancy Prevention Program

The cut is "shocking and unprecedented because it's extremely unusual," says Baltimore City Health Director Leana Wen. "I've never seen it happen that a grant is terminated without justification when the funds are available"
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TAYA GRAHAM: This is Taya Graham reporting for The Real News Network in Baltimore City, Maryland. New developments in the Trump administration's pushback against progressive policies, from defunding climate change research to blocking the use of the words "evidence based" in federal documents, the Trump's administration overt hostility towards science is no secret. But a recent move by the Department of Health and Human Services to abruptly end a program aimed at preventing teen pregnancies shows just how far-reaching the policy push is and how much of the efforts to roll back progressive reforms is taking place behind the scenes, with sometimes unseen consequences.

The $200-million, five-year teen pregnancy prevention program was an evidence-based effort to reach teen girls in the school and educate them about birth control and the consequences of having a child at an early age. The TPP, as it's known, was intended to run through 2020, but recently health departments across the country began receiving notice that the federal funding would be cut without explanation.

One of those agencies is Baltimore's Health Department, which today joined the lawsuit with other groups administering the program to sue the Trump administration to restore funding. We spoke to Baltimore City Health Director Dr. Leana Wen to understand how this happened and what it means for evidence-based approaches to solving complex social problems under an administration that seems to discount science whenever it can.

LEANA WEN: This is a five-year grant that the Baltimore City Health Department received from the Department of Health and Human Services, and it's to implement comprehensive science-based reproductive health education in all of our middle schools and high schools. A lot of what this grant does is develop capacity. In the last year, for example, we trained 115 teachers. We've also built a youth advisory council, where there are peer health advocates that would best advise teens. Importantly, the service affect 20,000 of our students here in Baltimore City.

Now this is a pilot, so the results have not come in yet. They wouldn't come in until the five-year period is done, but in July of 2017 we received--along with the other grantees--we received word from the Department of Health and Human Services that the grant would be terminated in three years instead of in five years, and that would be a cut to us of $3.5 million.

We have received no clear answers from the Department of Health and Human Services as to why this is the case, despite multiple letters from our Congressional delegation and multiple inquiries from the Congressional delegation. This cut to us is shocking and unprecedented because it's extremely unusual. In fact, I've never seen it happen that a grant is terminated without justification when the funds are available. Congress has approved for these funds to be there and there's no guidance about why this has occurred.

All of this is in the backdrop of the tremendous progress that we have made in Baltimore City. Between 2009 and 2016, teen birth rates in our city dropped by 61%, much higher than the national average. We still have a lot of work to do here in Baltimore City. We're so much higher in the national average overall for teen birth rates, so much higher than the state average. We know that teens have a higher rate of having low birth weight babies and pre-term births.

I'm a new mother and I can say that there's nothing more important to me than the health of my baby. My baby is now six months old, and I'm happy that he's healthy, and I would do anything to ensure that he is. We also know that the higher rates of teen birth rates and teen pregnancy also reduce educational attainment and opportunity for women, and for us it's about empowering women and families to have the best choices for themselves, and really this is the last thing that we should be doing, to roll back the gains that have been hard won.

STEPHEN JANIS: From your experience, you've had grants, this never happened where they just unilaterally cancel the grant and then didn't give you a reason? This is like a first time experience for you? Is that really like this never happens?

LEANA WEN: We have not had a case before in recent memory or in the memory of anyone in the Health Department that we've spoken to, or with my counterparts across the country, when a grant has been terminated even though the funds are available. Now the Department of Health and Human Services, they have issued responses back when pressured by our Congressional delegation and they've said that the results don't indicate that this program is working.

This is disingenuous, and in fact the New York Times editorial board has called them out as saying this is disingenuous because this is meant to be a planning pilot grant, so of course the results are not going to be made available. They've also said that the methods used are not evidence-based. This is simply untrue. We use evidence-based, science-based curriculum that's comprehensive in nature. We talk about anatomy physiology. We talk about STD prevention and we talk about HIV prevention. We use evidence based methods that are approved and are recognized by national councils and national committees, so cutting our grant without appropriate justification is unprecedented and disingenuous.

Speaker 4: Does the program involve birth control?


Speaker 4: The administration of birth control?

LEANA WEN: The program involves education on comprehensive reproductive health education, which includes prevention of teen birth and teen pregnancy. Of course that would involve the use of condoms and education on other methods of teen pregnancy prevention, which is the national best practice and science based best practice. We're very glad that as a result of all the efforts of our partners in our city, which include education, but also include providing services as well through our federally qualified health centers and in our schools and in our health systems that we have resulted in a decrease in teen birth rates by 61%.

Thinking about what that means is really incredible. Nationwide the cost of teen pregnancy is about $10 billion, and that was a 2010 number, so we're saving money. We're also improving the health of our babies and we're empowering women to make better choices for themselves, which will increase their educational attainment and economic stability going forward too.

STEPHEN JANIS: There is a lot of anti-science sort of seemingly culture in the Trump administration. Are you worried about other evidence-based programs that could be under threat because of this sort of move to eliminate these types of programs?

LEANA WEN: I'm a doctor and a scientist and I have to practice medicine according to what the science and research shows us to be true. That's my duty that I uphold as a physician, and certainly as a public health official. I don't know the justification for why this program is being cut. I would like a response, but most importantly I want for us to focus on the individuals that we serve and the loss of these critical services to our most vulnerable residents.

Speaker 4: How much money are we talking about? Do you know offhand the amount of the funding that's been ... Like year-to-year or whatever, that is involved for Baltimore, for Baltimore City?

LEANA WEN: Our entire grant is about $8.6 million and the cut is for $3.5 million, so it's a loss of $3.5 million for Baltimore City. Across the country I believe the total amount is over $200 million. My counterparts across the country are similarly affected. All of their grants ... All of our grants, I should say, have been terminated or changed from five years to a three-year termination, and so it's going to affect our most vulnerable teens and children and youth and families across the country, and for generations to come.

TAYA GRAHAM: We asked the Department of Health and Human Services for comment. They declined. This is Taya Graham and Stephen Janis reporting for The Real News Network in Baltimore City, Maryland.


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