Op-Ed Archive
Grantmaking for a Healthier California

A Prevention Success Story

March 2011

In 1992, when The California Wellness Foundation (TCWF) began developing a grantmaking program that would address teen pregnancy prevention, more than 70,000 California teens gave birth. It was cause for concern. For decades, California’s teen pregnancy rates had ranked among the highest in the nation.

In 1994, TCWF’s Board approved the Teen Pregnancy Prevention Initiative (TPPI) — a 10-year, $60 million comprehensive grantmaking program dedicated to preventing teen pregnancy in California through policy development, community action and support programs, public education and research. The work that began with the TPPI continues today as a funding priority under the Foundation’s Responsive Grantmaking Program. From 1995 to the present, TCWF has made 371 grants, totaling nearly $101 million, related to teen pregnancy prevention.

Since then, births to teenage mothers have dropped, reaching a record low in 2009. The most recent data released from the California Department of Public Health show a decline of more than 50 percent since the early 1990s, which experts have attributed in large part to the state’s substantial investment in teen pregnancy prevention education, programs and services that promote access to reproductive health care and contraception.

Had California continued to experience the same birthrate it did in the early 1990s — i.e., 71 births per 1,000 teens —the state would have had an additional 50,000 births in 2009. Each pregnancy averted saved more than $14,000 in public sector funds in medical, welfare and other social service costs for a woman and child from conception to age five. California’s prevention success represents a savings to society of $4.5 billion annually.

Experts have also recognized that private foundations such as The California Wellness Foundation, the William and Flora Hewlett Foundation, and the David and Lucile Packard Foundation, have played important roles that contribute to California’s teen pregnancy prevention success.

TCWF’s commitment has been expressed by grants to fund innovative teen pregnancy prevention efforts, including the “peer provider” or teen clinic model. Originally developed by Valley Community Clinic in North Hollywood, this model has consistently demonstrated its effectiveness at increasing the number of young people who access reproductive health services and use contraception. Key to its success is employing the skills of young people who work as peer providers at the clinic, which provides low- or no-cost family planning services, counseling and education. The increased use of contraception among sexually active teens is the single most frequently cited factor in contributing to California’s decline in teenage pregnancy. This is testimony to the fact that when young people are provided with accurate information and have access to reproductive health care, they will make responsible decisions.

Another highly effective model at preventing pregnancy among sexually active young people is the Adolescent Family Life Program (AFLP). The AFLP is designed to enhance the health of pregnant and parenting teens and their children and to work to avoid repeat unplanned pregnancies. This secondary prevention program is centered on a case management approach and boasts an impressive success rate with only about three percent of AFLP participants having repeat unplanned pregnancies — far better than the national average of 18 percent. This program has been replicated in 36 counties throughout California.

While California’s success in preventing teenage pregnancy is something we can all be proud of, it is not something to take for granted — especially when the state of California’s $25 billion deficit poses major challenges to state funding for prevention programs. At TCWF, we recognize these challenges and the heavy costs we will bear if teenage pregnancy rates should climb again. For this reason, we continue to provide grants for general operating support for programs like the peer provider clinics and the Adolescent Family Life Program that have proven, time and again, their effectiveness at preventing unplanned pregnancies. The enormous need — and the substantial return on investment — is abundantly clear from California’s experiences over the past two decades.

Gary L. Yates
President and CEO
The California Wellness Foundation

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