The Trump administration's decision to cut short a grant program that would have spent $214 million to support teen pregnancy prevention programs will have far-reaching consequences in cities across the United States, including Baltimore.
After the program ends next June, the city will lose the equivalent of $3.5 million in funding for a variety of programs aimed at curtailing unintended teen pregnancies. Another $880,000 grant funds research at Johns Hopkins' Bloomberg School of Public Health to evaluate a program to reduce sexually transmitted infections and pregnancy among American Indian teens
City Health Commissioner Leana Wen called the decision shocking and "unprecedented."
"We have not ever received a cut to an existing program without explanation, and when the funds were readily available," she said.
The cuts come at a time when the city has made significant gains in curbing teen pregnancies, which declined steadily over the past decade, she added.
Health department administrators from some of the other 80 affected cities also voiced disappointment. The grant program was supposed to fund their efforts over five years but now will end two years early.
The program's elimination was included in the budget President Donald J. Trump submitted to Congress in May for the Department of Health and Human Services, which did not respond to requests for comment. Even though the budget still is being considered by Congress, the department recently began notifying grant recipients that program funding would end in June 2018.
"The teenage pregnancy rate has declined significantly over recent years, but it does not appear this program has been a major driver in that reduction," the department said in budget documents.
Wen disagreed. "We know this program is impactful and effective," she said.
Baltimore's teen birth rate was 36.2 births per 1,000 women in 2015, the most recent data available — a significant 44 percent decrease from 2009, Wen said. But the city's rate remains twice as high as the rest of Maryland and greater than the national average, which was 22.3 births per 1,000 women ages 15 to 19 in 2015.
Wen said the funding loss will cause the city's teen pregnancy prevention efforts to lose momentum.
The grant currently goes toward science-based reproductive health education in middle and high schools, physiology and behavioral health courses, and other efforts to empower girls and teens to make good choices, Wen said.
About 20,000 students in 100 Baltimore schools will no longer be able to receive critical reproductivehealth education, Wen said. The city also won't be able to train 115 teachers and members of a youth advisory council that act as health advocates for their peers.
Wen said teen mothers are more likely to give birth to preterm and low-birth-weight babies and that their children generally have worse outcomes overall.
According to the Centers for Disease Control, just 50 percent of teen mothers graduate from high school before age 22. In contrast, about 90 percent of girls who don't give birth during adolescence earn their high school diplomas. Moreover, the children of teenage mothers are more likely to drop out of high school, be incarcerated during adolescence and face unemployment.