Has Colorado really had more success in preventing “teen” pregnancies than other states? Gov. John Hickenlooper said yes in a news conference convened within days of the U.S. Supreme Court’s recent Hobby Lobby decision. But the numbers cast serious doubt on his story.
According to the Denver Post, the governor said that the Colorado Family Planning Initiative led to a 40 percent drop in teen births over the past five years. Funded by a private, anonymous donor, the initiative provides IUDs and implants in 68 family planning clinics.
The article quoted officials who said that the birth rate for Colorado women 15 to 19 years old fell from 27 births per 1,000 in 2009 to 22 per thousand in 2013. To government health care programs, babies are a cost. So the reduced birth rates were said to have prevented $42.5 million in health care expenditures.
While it seems logical to associate a reduction in births with a new program for providing access to contraceptives, the Youth Risk Behavior Survey suggests that U.S. adolescents’ contraceptive use was unchanged from 2007 to 2013. The data also show that birth rates for 15, 16, and 17 year olds declined by 63 percent between 1991 and 2012.
According to the Centers for Disease Control, Colorado experienced a 31 percent drop in teen birth rates from 2007 to 2011. Colorado’s downward trend is similar to declines in Idaho, Florida, and Minnesota, but lower than the 35 percent decline in Arizona and Utah.
For the sake of argument, let’s assume that reducing births by 15-19 year olds is a reasonable policy goal, even though in 2012 the National Vital Statistics Reports attributed about 10 percent of 18 year old births, and 16 percent of 19 year old births, to married women. As a whole, 18 and 19 year olds account for about three-fourths of total “teen” births.
And let’s assume that having the state fund programs with money from private anonymous donors is perfectly fine public policy, even though it invites corruption by providing a channel through which rich, well-connected people can buy the public policies they want.
State programs to increase contraceptive use are presumably aimed at the relatively small fraction of sexually active “teens” who do not use contraceptives. Estimates suggest this group makes up about 13 percent of sexually active 15 to 19 year olds. Not all teens are sexually active. About half of high school students reported having sex in the 2013 Youth Risk Behavior Surveillance Summary, a fraction that is lower than the 54 percent reported in 1991.
As one would expect, the 13 percent of sexually active teens who do not use contraceptives accounts for about half of unintended teen births, according to 2004-2008 estimates from Pregnancy Risk Assessment Monitoring System.
Contrary to what state officials implied, “access” to contraceptives does not appear to be a widespread problem in the group that declined to use them. About 1 in 7 of the people surveyed in the sexually active non-using group said they had trouble getting birth control. If accurate, this suggests that in a group of 100 sexually active people aged 15 to 19 fewer than 2 reported that contraceptives access was a problem.
Taking them at their word, roughly 7 percent of unintended “teen” births were potentially due to a lack of contraceptives. However, in the same survey over a fifth of those who did not use contraceptives, and who said that they had an unintended birth, also said that they “did not mind” getting pregnant.
Perhaps the teen contraceptive access problem was particularly acute in Colorado and was solved by Hickenlooper’s secret donor. But it is also possible that access to contraceptives is almost universal for this group, that state programs have reached a point of diminishing returns and that the drop in teen births has more to do with a long-term change in public attitudes than a privately funded program run through a compliant executive branch.
Linda Gorman is director of the Health Care Policy Center at the Independence Institute, a free market think tank in Denver.
