Advocates for Youth, a Washington-based non-profit focusing on adolescent sexual and reproductive health, has released an analysis showing that teen sexual health outcomes in the U.S. lag far behind those in France, Germany, and the Netherlands

The U.S. teen birth rate, for example, is nearly nine times higher than that in the Netherlands, and four times higher than that in France and Germany. The U.S. teen abortion rate is twice that of Germany and the Netherlands. America's teen gonorrhea rate is 28 times greater than that in the Netherlands.

The Advocates for Youth study estimates that if the U.S. had a teen birth rate equivalent to that of the Netherlands, the number of U.S. teen pregnancies would be reduced by 617,000 and the first-year savings to taxpayers would be at least $542 million.

One of the key reasons that the U.S. lags behind other developed countries when it comes to teen sexual and reproductive health, is our failure to invest in comprehensive, age-appropriate sex education. Over the last decade, the U.S. government has spent over $1.3 billion on abstinence-only-until-marriage programs which prohibit information about condoms and birth control. In April 2007, a government-financed evaluation determined that abstinence-only programs simply do not work.

While the U.S. government and Congress have been slow to change and invest in programs that do work, local communities are now starting to take the lead.

In Cleveland, Ohio, the local school district in conjunction with other civic, health, and private sector leaders, recently launched a K-12 age-appropriate, comprehensive sex education initiative. On Monday, January 5, 2009, Frank Jackson, the Mayor of Cleveland held a press conference releasing an interim evaluation of the program, which showed strong and encouraging results (

-- Students in 1st through 3rd grades reported they learned about good touch/bad touch, what to do if someone tries to touch them inappropriately, and about respecting others;

-- Students indicated they are more likely to behave responsibly, such as stating they would not allow themselves to be coerced into sex;

-- High school students had significantly better attitudes regarding protecting themselves and their partners if and when they choose to engage in sexual activity; and

-- Parents and teachers overwhelmingly believe these lessons are important for their children and students.

Though the Cleveland program started in 2006 -- too early to evaluate behavioral as opposed to attitudinal outcomes -- the program is promising when viewed in conjunction with other recent research demonstrating that adolescents who receive comprehensive sex education have a lower risk of pregnancy than adolescents who receive abstinence-only or no sex education.
"Numerous studies have established that students who receive age-appropriate, medically accurate education about their bodies and how to protect themselves from disease and pregnancy are able to make healthy decisions," said Marcia Egbert, chair of the Cleveland Collaborative for Comprehensive School-Age Health. Cleveland is helping to turn the page on sex education policy in America by embracing the evidence-based approach supported by the leading medical and public health organizations in the country" (

The Cleveland initiative is a model for future progress and it is time for Congress to "end the decade of denial" and invest in programs that work. Each year teen pregnancy costs U.S. taxpayers over $9 billion with teen STDs adding another $6 billion to the tab. Cleveland has shown us the way to move forward. The new Obama administration and the Democratic-controlled Congress must act to end funding for failed abstinence-only programs and put taxpayers' money where the science is -- in comprehensive sex education

Advocates for Youth