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.
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.
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?
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.
Does the program involve birth control?
Yes.
The administration of birth control?
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.
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?
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.
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?
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.
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.