Want to Prevent Teen Pregnancy? Pay Teens Not to Get Pregnant

We use financial incentives in many areas of life for a simple reason: they work. Why not with teen pregnancy?

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NYC.gov

New York City officials recently spent $400,000 on billboards featuring omniscient babies who remind potential mothers about deadbeat dads of the future: “Honestly, Mom, chances are, he won’t stay with you. What happens to me?” In another ad, a crying infant says, “I’m twice as likely NOT to graduate high school because you had me as a teen.”

The shame-and-blame campaign almost immediately drew fire from Planned Parenthood and other health care providers who argued that the ads marginalize young women who are in need of services, not scarlet letters. But a spokesperson from Mayor Michael Bloomberg’s office defended the public-service announcements on the grounds that they are but one component of a multifaceted approach that includes school clinics and sex education, noting, “It is well past time when anyone can afford to be value-neutral when it comes to teen pregnancy.”

(MORE: The Argument You Don’t Hear About Birth Control in Schools)

Fair enough. But if we want to get serious about values, we might try an approach with a much more successful track record of behavior change: paying teenagers not to get pregnant. For every person who makes it to age 21 without becoming pregnant or impregnating someone else, the government should dip into the funds we’d otherwise spend caring for infants and teen moms and instead pay a significant cash bonus directly to the young person.

Sex and money have always been drivers of human behavior, but health officials rarely exploit this synergy to maximum benefit. Cash payments to teens could be doubly effective, reducing the number of teen pregnancies (which are declining nationwide but are still high relative to those of other developed countries) while producing what researchers call a “secondary outcome” by teaching self-regulation, patience and the ability to plan for the future—all valuable life skills.

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The New York City ads serve a useful function only insofar as they reassure indignant taxpayers that something is being done about wayward teenagers. But it’s wishful thinking to imagine that snarky speculations about a baby’s future are hitting their target audience of sexually active 15- and 16-year-olds. It’s not that negative advertising can’t work. Political campaigns use it all the time. But decades of research show that teens, like most people, respond to public health campaigns that seem personally relevant and offer concrete action steps. This explains why the infamous anti-smoking ads featuring photos of old, diseased lungs didn’t impress teen smokers as much as newer ads that say smoking is not normative in their peer group or connect them to resources to quit.

We already know that people respond to negative financial incentives. Smoking rates went down as cigarette taxes increased (even when other variables were accounted for). But there is also compelling evidence that people will change their behavior when offered positive financial incentives. A large randomized, controlled trial conducted by Kevin Volpp at the University of Pennsylvania and published in the New England Journal of Medicine in 2009 showed that a $750 incentive roughly tripled the success of smoking cessation, from 5% to 15%. In a recent survey of attitudes to cash payments, 73% of respondents said they would try to lose weight if the government paid them. Half said they would try “really hard.” And Harvard professor Roland Freyer has found that sensibly structured cash payments that are tied to specific goals, like reading more books, can yield good results for complex problems like keeping kids in school.

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Giving teens money to forestall pregnancy makes some people uneasy — why should we pay them to do something they “ought” to be able to manage on their own? — but we use financial incentives in all areas of life, from children’s allowances to tax breaks for home ownership, for a simple reason: they work. In a country steeped in practical values and unrestrained capitalism, it is surprising that we haven’t already put this solution to more widespread or better use.

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33 comments
pendragon05
pendragon05

I have a far superior idea - raise girls to NOT be dependent upon a boy for "love." Then they won't get pregnant as teens.

SprocketComm
SprocketComm

Though some of the content is controversial, we applaud anyone's effort to combat unwanted teen pregnancy. At BC4U, which is headquartered in Denver, we reach young adults ages 12-24 by providing completely free and confidential birth control (plus STD tests and more). The program has found a lot of success through social media and untraditional tactics. Here's a link to learn more: http://www.bc4u.org/

DBarbaraMcwhite
DBarbaraMcwhite

I am an ax murderer...pay me to not kill

I am a drug dealer...pay me to not sell drugs

I am a burglar... pay me to not steal

I am a wife beater ...pay me to not beat my wife .

I am a pedophile...pay me to not rape children

I am a tax cheat ...pay me to pay all ,y taxes

..................................get the picture????????

RalphJones
RalphJones

Have seen a couple of articles on this subject and they both roll out the "shame and blame" moniker to describe these ads.  Frankly, when did pointing out the undesirable consequences of ones' behavior become the shame and blame game?  Did I miss the scarlet letters that are being sewn onto the clothing of all pregnant teenagers as part of the campaign?  I think not.

This author, as did others, suggests that the campaign will be ineffective, and that may well be true.  She mentions that ad campaigns which suggest that certain behaviors are "not normative to their peer group" might be more effective but then discards this line of thought entirely.  After all, isn't telling someone of that age that their behavior is not normative to their peer group stigmatizing them?  We certainly wouldn't want them growing up with the idea that they are somehow UNCOOL.  Better to enhance their self-esteem by paying them money for doing nothing, just like we will for the rest of their lives.

dollarsandsex
dollarsandsex

Why not just pay teens to  have abortions? The effect of the payments at age 21 will essentially have the same effect (they will increase abortions instead of decreasing pregnancy) and will be much more cost effective. After all, only 3.5% of teens become pregnant in any one year. There is no point paying all of them to control their fertility when most of them are anyhow. 

misterplush
misterplush

This is an interesting but flawed idea.  Teenagers do not generally weigh the consequences of their actions thoroughly and a financial bonus in 6 years will probably not change a 15 year old's mindset.  Six years is a long time for anyone to wait, but 6 years to a teenager, who wants everything now, might as well be 100 years. Any savings society may obtain by the few whose behavior is actually changed by this plan, will be outweighed by the costs of giving money to the ones who weren't going to have a baby anyway.

bibleverse1
bibleverse1

Its cheaper than 18 years or more of support.

mi96romeo
mi96romeo

Women getting a scarlet letter?  Quote "reminding potential mothers about deadbeat dads of the future" the only sex being maligned is, yet again, the male of our species........

shannyraff
shannyraff

I believe it is a waste of government money to pay teens to do something they should already be doing on their own. It is not the government's responsibility to make sure these teens do not make mistakes, that is the job of the individuals themselves as well as their parents or guardians. That money could be better spent on other issues.

aatomwilkinson
aatomwilkinson

Many commenters have stated that the article or the journalist is 'stupid' for suggesting this.  I think this attitude is a reflection of the basic split in this country between the ideologues and the pragmatists.   I agree that 'teaching morals' might be superior to paying incentives, except that it doesn't actually work.   Teens going through abstinence-only programs have a higher rate of pregnancy then teens who get decent sex ed.  This evidence will not sway people who care only about ideology.    

JohnForsthoffer
JohnForsthoffer

This has to be a joke or a test to see how many people will respond because I don't think anyone is this stupid. Maybe we should pay journalists for not writing idiotic b.s. like this.

raidx259
raidx259

How far have we come from "ask not what your country can do for you ..."

kevin.f.jackson
kevin.f.jackson

This is a truly idiotic idea expressed in a terrible article (argument: people respond to money incentives, let's pay people to NOT do things that are bad for society. Hmm.... great idea, except we'd go broke

Are we just going to pay every single person in the US that makes it to 21 without having a baby? 

Just do some math and you'll realize that unless we're paying them a dollar each (which won't motivate anyone) that is a ton of money. 

God this is a stupid article

irene
irene

As a nineteen year old female, this might be the most unintelligent published article I have ever read. If instituted, my generation and ones that follow will have a complete lack of personal and social responsibility. Morals should be taught at home and encouraged by society, not just a reward for practicing common sense. 


raidx259
raidx259

No thank you. Everybody should be responsible for their own actions.

If you think you are old enough to have sex, then better be old enough to deal with the consequences.

mtngoatjoe
mtngoatjoe

Give all women free, long-acting reversible birth control (LARC). 

According to Wikipedia: "They are the most effective reversible methods of contraception because they do not depend on patient compliance. So their 'typical use' failure rates, at less than 1% per year, are about the same as 'perfect use' failure rates. Women considering using LARCs should obtain contraceptive counseling from reproductive health professionals because those who do are more satisfied with them and use them for longer periods of time."

This is really a no-brainer for me.

adnan7631
adnan7631

ARE YOU KIDDING ME??? YOU WANT ME TO PAY MONEY SO THAT SOMEONE ELSE'S GIRL GET'S AN INCENTIVE TO BEHAVE RESPONSIBLY?

Uh, No. 


fcs251
fcs251

Are you really this stupid? How about a novel idea.....Teach morals 

misterplush
misterplush

Crime rate is high, maybe we should pay people for each year they don't murder anyone.

tom.litton
tom.litton

@misterplush Agreed.  Before going any further with this idea you need to:

1. Prove that it works.  It leads to significantly less pregancies.

2.  Prove that it's financially viable.  The cost (not just the amount payed, but the overhead too) is about the same or less than the amount saved in financial aid to young mothers.

mike50
mike50

@mi96romeo  Yes true the male getting "maligned" but where unwed pregnancies are concerned it is the female that is almost always left holding the baby - literally. 

tom.litton
tom.litton

@shannyraff Your looking at it the wrong way.  Not getting pregnant until you are financially able to provide for a child saves the government a lot of money in terms of child care/food stamps, etc (not even including the extra taxes the person would pay if they went to college and got a better job).  

Why not share some of those savings with the person?  It's cheaper for everyone.

elchristakis
elchristakis

@kevin.f.jackson But the math has been done, by many people. That's precisely the point:  research shows, again and again, that carefully designed financial incentives SAVE society money, by eliminating behaviors that carry huge societal costs for all, not just the individual. There are many cases, such as smoking cessation, multi-drug resistant Tuberculosis etc. etc.. Furthermore, by asking a person to work toward a monetary reward, financial incentive programs can help teach young people precisely the important life skills -- such as the ability to delay gratification and regulate personal behavior - that kids who get pregnant in their teens obviously lack, ie judgment. The most successful programs link financial incentives to achievable goals and tie the monetary reward to other, non-financial support. One such program is College Bound Sisters, which targets girls most at risk (whose sisters have already become teen moms). Behavior change is extraordinarily hard (and the two thirds of overweight and obese Americans know this all too well). What many commenters fail to see is that these programs are not only economically sound but do, in fact, teach the morals and responsibility many teens lack. But people are squeamish about admitting that all humans operate, to varying extents, on an incentive plan.

mike50
mike50

@irene You are so right Irene, but the problem is manners, ethics and social responsibility are very often not being taught at home.

Hollywooddeed
Hollywooddeed

@raidx259 Tell it to the 12 and 13 year-olds I take care of everyday in labor and delivery.

tom.litton
tom.litton

@raidx259 The problem with that argument is that the financial consequences are partially payed by the government.  

Does the government not have a moral obligation to fulfill it's obligations and efficiently as possible?

tom.litton
tom.litton

@misterplush So long as the money saved by reducing the prisoner population is more than the money payed to the people, why not?  I pay less in taxes and less people get murdered.

shannyraff
shannyraff

@tom.litton @shannyraff I see your point, but I still don't believe that this money should be handed out to every teen that does not get pregnant. If the government is saving this money it means they are not obligated to spend it on this issue, therefore it should be put towards something else. Responsibility does not need to be taught through bribery from the government.

raidx259
raidx259

@tom.litton   maybe if a study was made that indicated that paying teens not to have children is, at the end of the day, less expensive for the government and society overall that would be one thing. But which teens do you pay? Every teen out there? Or just the ones deemed 'high risk'?

dcn94133
dcn94133

@shannyraff @tom.litton I'm pretty sure this is the first convo I've ever seen here where two people here with different opinions actually exchanged ideas and didn't end the convo with "nazi republican" or "democrap". Congrats to both of you. Oh and in case u are wondering, f-republicans :-).

tom.litton
tom.litton

@shannyraff @tom.litton So are you saying paying people not to have children is so morally objectionable to you that you would rather pay more money to take care of the mother and child (who will likely spend their life in poverty, with all the consequences that entails)?