Misguided Idealism
Wednesday, October 27th, 2010I have an idea. We should stop giving the measles vaccine. Obviously the measles is a serious medical condition, and yes, there is a proven and effective vaccine for it. But I think we should stop giving it to kids. They need to learn to take control of their health and I think we should stop the spread of measles by encouraging personal responsibility among children. We should teach kids not to interact with other children who might have the measles. We should tell them not to trade lunchbox items with kids who could be infected. And we should teach them that they’ll have to deal with the consequences if they end up catching the measles. Okay?
Not okay.
I hope you know I’m kidding. That entire paragraph was dripping in satire and sarcasm. I want to be clear about this: I do not believe we should get rid of the measles vaccine. Obviously, in this case the measles vaccine is an analogy. But for what? So glad you asked: Sex education. (In case the big picture of a condom tip you off…)
Last week I read this article about teen birth rates which was written in response to a new report from the CDC. I learned that in Connecticut, New Hampshire, Massachusetts, and Vermont – where comprehensive sex education programs are in place – teen birth rates were less than 25 per 1,000. In Oklahoma, Arkansas, New Mexico, Mississippi, and Texas – states which emphasize abstinence – teen births numbered more than 65 per 1,000.
I both was and was not surprised by these numbers. That teen birth rates would be higher in the South? Not so shocking. That teen birth rates are up to three times higher in the South? I didn’t see that one coming. But really, what surprised me the most about the article were not the statistics themselves, but my own response to them.
For the first time I thought about teen pregnancy as a health issue. Why I’d never cast it in this light before baffles me. I had thought about it as a social problem or a cultural problem, but not a health problem. And yet, its ranking as a health problem is much more significant than anything else. Teens are far less likely to have planned their pregnancies. As such, they are also far less likely to be educated about prenatal care, to understand how to maintain a healthy lifestyle during pregnancy, or to have regular OB visits. And those are just the physical issues. Teen moms also face a whole host of psychological issues such as embarrassment, shame, and fear just to name a few. And then, of course, are the risks to the baby. According to the CDC report babies born to teen mothers “are at higher risk of being born prematurely, having low birth weight and dying during infancy.” This is clearly more than just an issue of who’s loose between the sheets.
So, if teen pregnancy is a health issue, and if significant statistical evidence tells us that teen birth rates are up to three times higher in states that do not offer evidence-based sex education than in states that do, then why is it not being treated like one? Most of the media coverage of teen pregnancy speaks in terms of moral values and social stigmas. But this isn’t a function of conservative versus liberal or religious versus agnostic. It’s a function of healthy versus not healthy.
Do I believe that teenagers should be having sex? No. Do I believe that they would be better off choosing abstinence? Yes. But the evidence tells me that abstinence-only education does not work and I cannot ignore that. I believe that those people who advocate for abstinence-only education have their hearts in the right place. But their idealism is totally misguided in its application. If we really care about preventing teen pregnancy (and STDs!) then we need to educate our teens about safe sex. Kids are clearly going to have sex either way*, so we need to do what we can to ensure that they’re protected. Anything else feels a lot like getting rid of the measles vaccine to me.
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