Obama's Smart Sex Education Funding

Although health care has dominated the policy sphere as of late, I wanted to call attention to the sex-education funding in the 2010 Appropriations Bill for the Departments of Labor, Health and Human Services, and Education, and Related Agencies. The 146-page bill is, to be fair, not a Twilight-caliber page turner, but it does tackle sex education, a hugely contentious issue during the Bush administration, when $1.8 billion was appropriated for abstinence-only education.

Here's the Obama approach to the issue:

$100,000,000 shall be for making contracts and competitive grants to public and private entities to fund medically accurate and age-appropriate programs that reduce teen pregnancy; and for the federal costs associated with administering and evaluating such contracts and grants, of which not less than $75,000,000 shall be for replicating programs that have been proven through rigorous evaluation to delay sexual activity, increase contraceptive use (without increasing sexual activity), reduce the transmission of sexuallytransmitted infections or reduce teenage pregnancy; and of which not less than $25,000,000 shall be available for research and demonstration grants to develop, replicate, refine, and test additional models and innovative strategies for preventing teen pregnancy or sexually transmitted infections.

What's so special about this paragraph? Two things:

First, notice it says nothing about "comprehensive" or "abstinence-only," which has long been the fault line in sex education. Either you teach how to use contraceptives, or you teach students that sexual abstinence until marriage is the expected standard. But instead of becoming embroiled in this longstanding debate (one that, to be honest, has little chance of being resolved any time soon), this budget does a smart side step. It basically says "what matters most isn't what you teach, but the results that you get." Abstinence-only, abstinence-plus, abstinence-centered, or comprehensive: any of these programs would be able to compete for funds as long as they can prove that they work. Which, at the end of the day, gets sex education focused on what most Americans want: reducing pregnancies and reducing sexually transmitted infections.

Second, the program has a nice breakdown between funds for proven programs and research. Which I think is indicative of what we're going to see in the larger scheme of health-care reform in the Obama era: mostly funding things that are proven to work but also a significant budget for things that might work. In this case, that means spending a quarter of the budget researching "innovative strategies." This is exactly what Atul Gawande wrote about in a recent New Yorker article, emphasizing the importance of small experiments in widespread health-care reform:

At this point, we can't afford any illusions: the system won't fix itself, and there's no piece of legislation that will have all the answers, either. The task will require dedicated and talented people in government agencies and in communities who recognize that the country's future depends on their sidestepping the ideological battles, encouraging local change, and following the results.

In the case of sex education, better methods are most definitely needed: at best, only two thirds of comprehensive sex-education programs reduce just one risk factor (like the rate of teen pregnancy or of contraceptives use). Meanwhile, the past two years have seen an uptick in teen pregnancies. Most of us can agree both of these areas are ones where we could stand to see improvement. And, hopefully, with ideological battles sidestepped, we will.