Teen Pregnancy and Teen Pregnancy Prevention: National, State, and Local Costs

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Teen Pregnancy and Teen Pregnancy Prevention
National, State, and Local Costs

• A Teleconference Presentation
• by
• Wilhelmina A. Leigh
• Joint Center for Political and Economic Studies
• for
• Northeast Regional Public Health Leadership
  Institute
• SUNY Albany School of Public Health
• May 13, 2004

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Purpose of Presentation

• To explain how the following costs can be
  estimated cost of the consequences of teen
  pregnancy, and cost of (or expenditures for) teen
  pregnancy prevention
• Estimates at the national, state, and local
  levels of government will be reviewed.
• Presentation is based on research conducted
  between late 1970s and early 2000s.

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Outline of Topics

• Costs incurred by federal, state, and local
  governments as a consequence of teen pregnancy
• Costs to (or expenditures by) federal, state, and
  local governments to prevent teen pregnancy
• Comparison of the cost of consequences of and
  the cost of prevention of teen pregnancy
• Conclusion

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Cost of Teen Pregnancy - Topics Costs incurred
by federal, state, and local governments as a
consequence of teen pregnancy ...

• Measures/Definitions
• Estimates
• Methodologies
• Related Issues

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Measures of Cost of Consequences of Teen
Pregnancy

• Single-year cost (and single-year cost saving)
• Single-birth cost (and single-birth cost saving)
• Single-cohort cost (and single-cohort cost
  saving)
• Economic cost (in a single year)

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Definition Single-Year Cost of Teen Childbearing
cost to a level of government (or to
taxpayers) in a given year to support all
families (or households) that were begun as the
result of teen childbearing, even those families
in which the mother is no longer in her teens
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Definition Single-Year Cost Saving Due to
Averting Teen Pregnancy public expenditures
that would not have been incurred if all first
births to teens that created families (or
households) who received government support in a
given year had been postponed until the mothers
were at least 20 years of age
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Estimated Single-Year Cost and Single-Year
Cost SavingFederal government, FY 1989 cost
21.55 billion cost saving 8.62
billion----------Local Example Baltimore, MD,
FY 1989 cost 246.1 million
cost saving 98.4 million-----------Source
Armstrong Waszak (1990)
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Definition Single-Birth Cost of Teen
Childbearing cost to a level of government
over the succeeding 20 years to support a family
(or household) begun by a teen birth in any given
year
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Definition Single-Birth Cost Saving Due to
Averting Teen Pregnancy saving in government
expenditures that would result over a 20-year
period if each of the teen births in the initial
year of this period were postponed until the
mother was at least age 20
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Estimated Single-Birth Cost and Single-Birth Cost
SavingFederal government, 1989-2008 cost
16,975 cost saving 6,790Source Armstrong
Waszak (1990)-------California, 1985-2004
cost 17,942 cost saving 7,177Source
Brindis Jeremy (1988)
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Definition Single-Cohort Cost of Teen
Childbearing cost to a level of government
over the succeeding 20 years to support all
families (or households) begun by births to
teenagers in any given year
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Definition Single-Cohort Cost Saving Due to
Averting Teen Pregnancy saving in government
expenditures that would have resulted over a
20-year period if all of the teen births in the
initial year of this period had been postponed
until the mothers were at least 20 years of age
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Estimated Single-Cohort Cost and Single-Cohort
Cost SavingFederal government, 1989-2008 cost
6.35 billion cost saving 2.54
billionSource Armstrong Waszak
(1990)--------California, 1985-2004 cost
717.6 million cost saving 287
millionSource Brindis Jeremy (1988)
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Methodology for Estimating Cost of the
Consequences of Teen PregnancyAppropriate
fraction(s) of the expenditures by a given level
of government for various public programs are the
constituents of the estimates of single-year,
single-birth, and single-cohort costs (and
associated cost savings).
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Methodology for Estimating Cost Saving Due To
Averting Teen ChildbearingRule of thumb is to
take 40 percent of estimates of government
single-year, single-birth, and single-cohort
costs associated with teenage childbearing
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Methodology for Estimating Cost of Consequences
of Teen PregnancyGovernment program
expenditures most often included in cost
estimates of the consequences of teen pregnancy
- Welfare- Medicaid- Food Stamps
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Methodology for Estimating Cost of Consequences
of Teen Pregnancy Relevant government program
expenditures less frequently included in cost
estimates - Education- Juvenile Justice- WIC
- Homeless Assistance
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Methodology for Estimating Cost of Consequences
of Teen Pregnancy Additional government program
expenditures less frequently included in cost
estimates- Child Welfare (foster care)-
Mental Health Services- Substance Abuse
Treatment- Child Support Enforcement- Housing
Assistance- Job Training
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Economic Cost of Teen Pregnancy

• Includes public expenditures plus tax revenue
  lost plus lost earnings
• Also termed opportunity cost or indirect cost
• Can be calculated from several perspectives --
  e.g., taxpayer (or government), teen parents, and
  society

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Estimated Economic Cost of Teen PregnancyState
Example South Carolina --Single-year (FY 1995)
economic cost of teen pregnancy 1.5
billionSource Parker (1997)
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Methodology for Estimating Economic Cost of Teen
PregnancyConstituents of cost estimate

• Public assistance/government program expenditures
  (as in cost estimates of the consequences of teen
  pregnancy)
• Estimates of lifetime earnings (prorated)
• Estimates of sales taxes not paid
• Estimates of income taxes not paid

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Issues Related to Estimating Cost and Cost
Saving Associated with Teen PregnancyMacro
Issues Affecting Estimates

• Public-sector versus private-sector costs
• Difference between the costs of pregnancy and of
  childbearing
• Co-mingling of federal and state/local funds
• Availability of expenditure data for government
  programs

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Issues Related to Estimating Cost and Cost
Savings Associated with Teen PregnancyMicro
Issues Affecting Estimates

• Treatment of direct and administrative
  expenditures in government programs
• Estimating the appropriate proportion of program
  beneficiary families (households) begun by teen
  childbearing
• Availability of data for various government
  programs at desired units of geography

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Cost of Teen Pregnancy Prevention - Topics
Costs to (or expenditures by) federal, state, and
local governments to prevent teen pregnancy ...

• Measures/Definitions
• Estimates/Methodologies
• Related Issues

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Measures of Cost of Teen Pregnancy Prevention

• Single-year cost of teen pregnancy prevention
  (i.e., total spending, or expenditures made in a
  single year to prevent teen pregnancy)
• Spending per female teen to prevent teen pregnancy

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Definition Single-Year Cost of Teen Pregnancy
Prevention cost to those who paid the federal
and/or state and local taxes that covered
expenditures to prevent teen births in a given
year and in a given jurisdiction
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Estimated Single-Year Cost of Teen Pregnancy
PreventionFederal government, FY 1996 cost
138.1 millionSource Feijoo (1999)--------Fede
ral government, FY 1997 cost 164 million
(minimum)Source US GAO (1998)
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Estimated Single-Year Cost of Teen Pregnancy
PreventionState Example 17 Southern states
(plus DC, PR, and USVI), FY 1995 -- Single-year
cost of teen pregnancy prevention 122
millionSource Kreutzer (1997)
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Estimated Single-Year Cost of Teen Pregnancy
Prevention, by StateTotal of Federal and State
Funds Per State for TP Prevention --

• Georgia, FY 1998 15.02 million
• Illinois, FY 1997 18.2 million
• Vermont, FY 1997 627,015 Source
  US GAO (1998)
• WDC, FY 2002 6 million
  Source DCCTPTP (2002)

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Estimated Cost of Teen Pregnancy Prevention, Per
Female Teen, 1997

• Mississippi 0
• Nebraska 0
• Nevada 0
• Hawaii 5
• California 78
• Median 8
  Source Wertheimer Moore (1998)
  

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Estimating the Cost of Teen Pregnancy
PreventionIssues

• Medical sector (both public and private) cost as
  well as government cost
• Co-mingling of federal and state/local funds
• Actual and permissible uses of block grants
• Identifying programs that prevent TP
• Availability of data for smaller geographic units

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Cost of Consequences of TP v. Cost of TP
Prevention, FY 1995 17 Southern states (plus
DC, PR, USVI) --Single-year cost of
consequences of TP 14 billionSingle-year
expenditures to prevent TP 122
millionSource Kreutzer (1997)
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Conclusion

• Methodologies used to estimate the cost of the
  consequences of TP and the cost of (or
  expenditures on) TP prevention are similar.
• Data underlying cost estimates may be
  problematic.
• However, the amount spent as a consequence of
  teen pregnancy is much greater than the amount
  spent to prevent teen pregnancy.

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Contact InformationWilhelmina A. Leigh,
Ph.D.Senior Research AssociateJoint Center for
Political and Economic Studies1090 Vermont
Avenue, NWSuite 1100Washington, DC
20005-4928Phone [phone]FAX
202-789-6390e-mail wleigh_at_jointcenter.orgweb
http//www.jointcenter.org