, Gloucester, MA

June 10, 2008

Officials say health education cuts may contribute to increase in pregnancies

By Patrick Anderson

Supporters of comprehensive sex education say cuts to funding for health education, both locally and across the state, are endangering efforts to reduce teenage pregnancy and may have some impact on the jump in pregnancies at Gloucester High School this year.

In 2003, the state, facing a fiscal crisis, stopped $25 million that had been going to the Department of Public Health and Department of Education for health education.

The money, which made up the Health Protection Fund, was available to school districts and groups providing health education that adhered to the state's educational frameworks, which include comprehensive sex education.

"What we hear from schools is not a reluctance to provide health education, but a lack of funds," Patricia Quinn, executive director of the Massachusetts Alliance on Teen Pregnancy, said yesterday. "Every school district had applied to and gotten some of that funding and none of it has been replaced."

Quinn said that with a reduction in sex education, the Alliance fears that knowledge about contraception among teens will decrease and that Massachusetts' long-declining teen pregnancy rate will rise.

School and city officials have been discussing strategies for reducing teen pregnancy since Gloucester High School reported pregnancies among students this year spiked to around four times the annual average.

Although the question of whether the high school health clinic should provide contraceptives has driven debate, officials working to formulate a comprehensive policy on the subject are considering whether changes to school health education should be part of the solution.

The high school health clinic provides pregnancy tests and some counseling. Girls that become pregnant, or express a need for more substantial reproductive services than the clinic offers, are usually referred to outside providers.

Health Quarters in Beverly is the nearest provider of confidential, low-income reproductive health services to Gloucester and one of the organizations that has lost out on state health education funding.

Lianne Cook, the executive director of Health Quarters, said yesterday that in 2002, her organization had eight full-time staff members providing sex education and outreach to the 45 cities and towns the organization serves and was active in Gloucester schools. But after the state budget decreases, Health Quarters had to scale back to only one full-time educator, Cook said.

"When state money went away, we had to cut back," Cook said. "There is a massive need. Schools come to us and say: 'Can you help us?'"

Federal funding for sex education is limited to "abstinence only" instruction which does not present contraception as an option.

A group of U.S. senators, including Kennedy and Kerry of Massachusetts, has proposed opening up the funding, $209 million proposed for fiscal 2009, to comprehensive sex education programs. The program, if not reauthorized, is set to expire June 30.

While the number of pregnancies at Gloucester High School has caught the attention of many leaders both inside and outside the city, public health officials so far have not been able to determine whether they are part of a larger, regional trend or an isolated event.

The latest statewide teen pregnancy data, which showed the rate was down slightly from the previous year, was compiled in 2006. The state does not collect school pregnancy data.

Cook said she did not have any evidence to support, either statistically or anecdotally, that more teens on the North Shore are becoming pregnant based on what she saw at Health Quarters. But Cook said it did not appear as though Gloucester was dealing with a unique problem.

"I don't think we have a good baseline," Cook said. "Seventeen is too many, but without a baseline, it is hard to measure what is happening."

Cook said the fact that the numbers reported by the high schools are for only positive pregnancy tests, not actual births, made them difficult to compare with rates collected for cities and towns, which are for actual births.

Brian Orr, the doctor serving the Gloucester High School Health Center, said nationally around 30 percent of teen mothers choose to have abortions and his experience indicated there was no reason to think the numbers at the high schools were far from that rate.

Orr said he was surprised by the number of girls at the health center who had been disappointed when pregnancy tests conducted at the clinic came back negative.

Quinn said although the Alliance on Teen Pregnancy did not have any statistics on teen births after 2006, she was hearing anecdotal reports of significant increases.

Quinn said she was concerned about the results of a national study released last week by the Centers for Disease Control that showed the percentage of teens that said they had used a condom the last time they had had sex in Massachusetts had declined from 65 percent in 2005 to 61 percent in 2007.

The total percentage of Massachusetts teens who had engaged in sex dropped during the same period, contrasting with a modest increase nationally, according the study, called the Youth Risk Behavior Surveillance System.

Gloucester public school students receive sex education during middle school and are required to take one health class during their freshman year of high school.

Mayor Carolyn Kirk, who is also a member of the School Committee, said yesterday that although sex education had not been specifically targeted for decreases in the last few years, the shrinking of the school budget in the last eight years had likely taken a toll on it.

"I know that as we cut budgets, the first things that go are things that are not graduation requirements," Kirk said.

Kirk yesterday said an effort being led by city Health Director Jack Vondras to provide the School Committee with expert analysis and information on teen pregnancy was progressing and the committee would hold a special meeting in the next few months to discuss the topic.

She said the committee might be ready to vote on a new comprehensive school policy to limit teen pregnancy by mid-August.

Patrick Anderson can be reached at