Rebecca A. Maynard

Teenage pregnancy and parenting are among the nation's greatest tragedies because of the burdens they impose on future generations. With the sharp increases in out-of-wedlock childbearing and a persistently high abortion rate, an especially strong link has emerged between teenage parenthood, long-term welfare dependence, and poor outcomes for children. The growth in the rate of out-of-wedlock childbearing, in turn, has paralleled expansions of the federal welfare safety net. At this juncture, there is substantial research to challenge the wisdom of past programs designed to prevent teenage pregnancy or to mitigate its consequences. Those programs were usually voluntary, nondirective, and focused on providing economic support. Their limitations suggest that more paternalistic policies linking public support for teenage parents and their children to specific parental and child behaviors would better serve both these families and society as a whole.

These conclusions are derived from two strands of empirical research. One is studies of child and adolescent development, which identify teenage pregnancy and parenthood as examples of the types of irrational behaviors common among adolescents, particularly those with inadequate external sources of behavioral controls. Teenagers do not intend to get pregnant and begin families at young ages. Moreover, doing so is at odds with their stated values. Yet more than 1 million become pregnant each year and just over half of those getting pregnant give birth. These statistics have worsened in the past few decades despite increased efforts to educate youths about sex and family planning and to increase both the availability and reliability of contraceptives.

The second strand of research has investigated the common features of the few effective pregnancy prevention or parenting policies and programs for teenagers. Those that have shown promise clearly state values, maintain specific behavioral requirements, and impose sanctions for failure to fulfill requirements.

This chapter first discusses the conflict between the values and actions of teenagers for teenage mothers and the implications of the half million births to teenagers each year for their children and for taxpayers. I then discuss public policies aimed at reducing teenage pregnancy and parenthood and the results. The chapter then examines in greater detail the practical lessons from the past two decades of policy and program evaluation research and assesses the current trend toward highly paternalistic social welfare policies. Not only are more paternalistic policies crucial to maintaining public support for social programs such as welfare, but they also offer the most promise for preventing teenage pregnancy and mitigating adverse consequences when it does occur.

Conflicts between Teenagers' Values and Actions

Each year more than a million teenage women in the United States become pregnant, 88 percent of them unintentionally.¹ More than 500,000 of them give birth, more than three-fourths of them for the first time. Teenage pregnancy and parenting are, of course, not new phenomena in the United States, but the face of this problem has changed dramatically in the past thirty years. Most notably, births occurring out of wedlock have risen from less than 30 percent of all teenage births in 1950 to more than 70 percent today. Indeed, only 18 percent of all teenage pregnancies end in the formation of traditional two-parent families.²

The increase in the incidence of these births has been accompanied by a steady decline in economic status and a corresponding increase in welfare dependence among teenage parents. More than three-fourths of teenagers giving birth out of wedlock end up on welfare for an average of eight to ten years.³ Most will be living in poverty ten years after their first child is born.

Teenagers are still children. As a group, those who unintentionally get pregnant and begin parenthood at a young age signal their inability to make decisions that are in their own best interests, the best interests of their children, and the best interests of society. Despite the rapid growth of school- and community-based health and education programs focused on adolescent and reproductive health, more teenagers are having sex at younger ages. And despite greater use of contraception and the availability of more effective means of contraception, the incidence of unprotected sex and the failure rates of contraception remain unacceptably high. As a result, the rate of teenage pregnancy remains unacceptably high.

Teenagers' poor judgment has been compounded by social policies that enable those who bear children in their teenage years to continue to make poor decisions. The federal social safety net provided by AFDC, food stamps, and medicaid has traditionally guaranteed teenage mothers basic economic security. The laissez-faire attitudes in this country toward fathers' responsibilities have enabled fathers of children born to teenage mothers, most of whom are not themselves teenagers, to escape responsibility.⁴

Pregnancies Are Unplanned

The vast majority of the million-plus teenage pregnancies occurring each year are not planned but result from unprotected sex or contraceptive failure. In the words of young mothers who participated in a federal welfare demonstration program: "I didn't plan it, and then again, I kind of knew that it was going to happen because I wasn't like really taking the pills like I was supposed to. I couldn't remember every day to take the pill. And, I still don't." "I really don't want to take time off . . . right now. . . . But, I'm allergic to birth control pills." "My boyfriend thinks [the pills have] something in there killing him."⁵

At the same time that teenagers are becoming sexually active at increasingly younger ages, they are intentionally getting married at increasingly older ages (figure 3-1). These changing goals no doubt contributed to their greater awareness and use of contraceptives. For example, in 1982 only 48 percent of teenagers used contraceptives during their first intercourse, but by 1988 the rate had risen to 65 percent.⁶ This increase in contraceptive use had not, however, been sufficient to keep increased sexual activity from raising teenage pregnancy and birthrates.

Figure 3-1.Sexual Activity and Marriage Rates among Teenagers, 1960_93

Percent

Source: Alan Gutmacher Institute, Sex and America's Teenagers (New York, 1994).

The most troubling aspect of the unplanned pregnancies is that more than 40 percent end in abortions, which pose both physical and mental health risks to the teenagers and financial burdens for them, their families, and society. In fact, many teenage mothers have had one or more unplanned pregnancies terminated through abortion before having their first baby.⁷

Dreams and Realities for Teenage Mothers and Their Children

As a group teenage mothers are no less excited about their newborns than are older mothers. And their goals for themselves and their children mirror those of the general population. They want to be good mothers and provide a good life for their children: "I have to get out of here. I can't stand it. No matter where you turn, all you see is this guy and that guy try'n to

sell drugs. I don't want my son to grow up with them. Sometimes little boys let other people influence them, and I don't want him to be growing up thinking that that's something tha' he has to do to make money." They want good jobs for themselves: "I think mothers should work. For one thing, your child gets to learn how to be with other children. And they learn to do little things that maybe you don't have time to teach them at home. So I think she should work, even just to help the child out a little." And they want supportive relationships with male partners, although many reject marriage as a short-term goal because they believe that married men can be too controlling or are not stable providers for themselves and their children. "When you're single it's better. They [the men] treat you so much better when you're not married, you know. . . . When you're single, it's honey this and honey that. When you're married, do this, do that."

Most also are adamant that they want no more children in the foreseeable future. As one said, "I just want to get into school and to work. I really don't want to take time off for no more children right now. I'm not ready for it now. When I have my own place, a full-time job, but not right now." Another added, "It's different when you don't know, when you don't have a kid. . . . I know how hard it is with one. How in the world would you make it with two?" Yet teenage mothers fail miserably in achieving these goals. They, their children, and the fathers of their children all suffer from early parenting decisions—the children most of all.

In general, children of teenage mothers exhibit worse health, greater use of medical care, greater poverty, and poorer school performance than their counterparts born to older mothers. Young parenthood itself is responsible for most of these disadvantages. For example, in 1987, 28 percent of former teenage mothers age 21 to 33 were poor compared with 7 percent of the women who had their first baby at age 20 or older. Only 43 percent of this difference is attributable to the fact that the teenage mothers came from more disadvantaged backgrounds.⁸

The troubles for children of teenage mothers begin before birth and continue into adulthood. Even after controlling for differences in backgrounds, the offspring of young teenage mothers have a 50 percent higher probability of having a low birthweight and subsequently having poorer health as compared with those born to women who begin parenting in their early twenties.⁹ The consequences of slightly older childbearing are similar in scope, if somewhat less severe. Despite having more health problems, children of teenage mothers, particularly young teenage mothers, get less medical care than if their mother delayed childbearing a few years.¹⁰ They also do much worse in school. They are 50 percent more likely to repeat a grade, perform much worse on standardized tests, and have a much lower rate of school completion.¹¹

In part these poor development and educational results may be related to the children's much higher rates of abuse and neglect. There are 110 reported incidents of abuse and neglect per 1,000 families headed by a woman who had her first child before the age of 18, compared with less than half that number among children born to mothers in their young twenties.¹² The results are only marginally better for children whose mothers delay childbearing until 18 or 19 years of age.

Not surprisingly, adolescent childbearing also contributes to the high rate of crime among sons and to the repetition of the cycle of teenage parenting. All else equal, simply being born to a mother younger than 17 rather than 21 increases by 13 percent (from 9.1 to 10.3 percent) the likelihood a male child will end up in prison and increases by 20 percent (from 13 to 16 percent) the probability that a female child will herself become a teenage mother.¹³

Unquestionably, those teenagers who get pregnant tend to have poor life prospects regardless of whether they become teenage parents.¹⁴ Still, the added complications of being a young parent, especially a parent before age 18, further disadvantages these young teenagers in ways that may undermine their efficacy as parents. For example, less than 35 percent of teenagers who begin their families before age 18 ever complete high school, compared with 85 percent of those who delay childbearing. Nearly half of this difference is caused directly by the young teenage parenting. Young teenage mothers also spend 60 percent more time as a single parent, thus shifting a disproportionate share of childrearing responsibility to the mothers and depriving the children of the benefits of two parents in the household.¹⁵

As a group the fathers of children born to teenage mothers bear little of the cost of adolescent childbearing compared to the mothers.¹⁶ Most are not themselves teenagers when they father children and less than 30 percent of them marry the teenage mothers of their children. The more than 70 percent who are absent fathers pay less than $800 annually for child support. Indeed, only a minority formally acknowledge their fatherhood, and fewer than half of those make regular child support payments.¹⁷

Spillover Costs for Taxpayers and Society

Unlike many life choices that primarily affect the individual, teenage pregnancy and childbearing affect the whole of society. Society pays for about 400,000 abortions for teenagers each year. It bears an even larger cost of teenage childbearing. One recent study estimated conservatively that childbearing by women under the age of 18 costs nearly $9 billion dollars annually, $7 billion of which is paid directly by the taxpayers.¹⁸ Including the costs of childbearing by 18 and 19 year-olds raises these figures by at least 75 percent. Thus the economic rationale for stronger public policies against teenage pregnancy is clear. And this ignores the intangible gains from minimizing the affront to social values represented by unwed pregnancy and abortion.

Teenage Sex, Pregnancy, and Parenting Behavior

In the past three decades the United States has witnessed trends in teenage behavior that would seem to invite more paternalistic social policies. Before 1970 premarital sex was openly discouraged, and those "found out" by getting pregnant faced social sanctions from their peers, adults in their families, and their communities. At the same time, contraceptives were not readily accessible to teenagers, and those methods available (primarily condoms and foams or jellies) tended to be less effective than many of today's options. Abortions were widely illegal. And public assistance was essentially nonexistent for teenage-parent families. Only 27 percent of teenagers were sexually active before age 18, and only 61 percent were sexually active by age 20.¹⁹ Although teenage pregnancy and birthrates were high by historical standards, the vast majority of the pregnancies occurred among 18 and 19 year olds who gave birth rather than having an abortion and who married the fathers of their children.²⁰

In the 1970s there were marked improvements in contraceptive technologies and in the accessibility of contraceptives to young people. Abortions were legalized in 1973, although they were still not easily available in many parts of the country and among lower socioeconomic groups. The rate of teenage sexual activity increased dramatically: most teenagers were becoming sexually active before their eighteenth birthday.²¹ At the same time, teenagers increased their rate of contraceptive use, and they more than doubled their rate of abortion, from 19 per 1,000 teenage girls to 43 per 1,000 by the end of the decade. As a result, the teenage birthrate approached its all-time low of about 50 per 1,000 women age 15 to 19, and the age at first marriage continued to edge up, reaching 22 by the end of the decade.

But the rate of births to unwed mothers steadily rose: by 1980 they accounted for 48 percent of all teenage births. The majority of these mothers turned to AFDC for support. This dramatic rise resulted in a steady increase in the number of out-of-wedlock teenage births despite the decline in the overall teenage birthrate.

The Policy Context

During the 1960s AFDC, which had primarily served divorced and widowed women, began primarily serving never-married mothers and their children. The 1970s marked the start of a new wave in social services; public assistance was more widely available and social service providers promoted empowerment among poor women, particularly poor single mothers. In the 1980s social services adopted a deficit model for service planning and delivery in which teenagers were seen as helpless clients in need of additional resources. Income and social support programs expanded their eligibility criteria and generosity, many of them assuming the qualities of entitlement programs. Between 1984 and 1991 funding for family planning services increased by 41 percent, outpacing the growth in the number of clients, which increased by only 31 percent.²²

The 1980s also witnessed an explosion of programs serving the reproductive health needs of teenagers, often through health clinics located in or near schools, as well as an array of programs to support teenage parents as parents and enable them to continue their education.²³ Many large comprehensive high schools instituted special programs for teenage parents, often with on-site day care for the babies. Throughout the country there was also a rapid increase in the number of community programs to meet the social, health, economic, and educational needs of teenage parents and their children. Initially the programs were supported primarily through private funds. But by the end of the 1980s many were incorporated into state and local welfare programs. Indeed, the Family Support Act of 1988 mandated that states serve teenage parents on AFDC who have not completed high school as a priority group in their Job Opportunities and Basic Skills Training (JOBS) programs.²⁴

By the middle of the 1980s teenage pregnancy rates and birthrates had stabilized, but the rate of out-of-wedlock births among teenagers continued to rise and by 1990 had reached 70 percent.²⁵

Currently, the United States has entered a period of public policy that psychologists might characterize as codependency. Policies enable teenagers to continue to bear children and suffer few social or economic sanctions. Despite myriad welfare reform initiatives throughout the country, most states still allow teenage parents to qualify for AFDC with only modest reciprocal demands or none. In the Family Support Act, Congress gave states authority to mandate school attendance or serious employment efforts by teenage parents. Yet eight years later most states still had not acted aggressively on this authority.²⁶ Only a small minority of unwed teenage mothers enforce the establishment paternity and child support payments on the fathers of their babies. In addition, current policies do little to address the high rates of rape and incest that have occurred among pregnant and parenting teenagers, especially those who give birth before age 16.²⁷ Finally, policies do nothing to hold the schools accountable for their lack of success with pregnant and parenting teenagers, even those states such as Florida, Ohio, and Wisconsin that have "learnfare" programs.

Incentives and Welfare

Nevertheless, conservatives' views that the welfare system itself promotes teenage pregnancy and parenthood have at best weak support, at least within the range of plans states implemented before passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.²⁸ There is little connection between trends in real welfare benefits and the trends in teenage pregnancy rates and birthrates. Similarly, there is little correlation between states' teenage pregnancy and birthrates and the generosity of their welfare benefits. Instead, during periods when benefits have eroded, the rates have tended to increase and vice versa.²⁹

Nor are changes in welfare incentives a clear answer to preventing teenage pregnancies. More than twenty states have implemented family caps, which end the practice of increasing welfare benefits if families have additional children. In taking this action states are sending a clear message that it is not acceptable for people to have children they cannot support. States are not, however, explicitly imposing penalties or social sanctions on those who bear additional children while on welfare. The states thus are not being truly paternalistic. Study findings are consistent with the fact that family caps impose only modest financial penalties and social sanctions for having more children while on welfare. The early results from the New Jersey Fed Wed program, begun in 1994, show little or no effect on the fertility of welfare recipients (adults and teenagers together) compared with that of control groups.³⁰

Pregnancy Prevention Efforts

In the past decade many program and policy initiatives have sought to encourage teenagers to delay sexual activity and prevent unplanned pregnancies. Most of the more than $600 million in annual expenditures for fertility control flow through a few national programs: medicaid, the Title X Family Planning program, the Maternal and Child Health Services Block Grant, and the Social Services Block Grant. Hundreds of other programs throughout the country also seek to reduce the incidence of teenage pregnancy. These include programs with a primary goal of promoting abstinence, "safe sex," or both. They also include programs with a much broader focus on the social and educational needs of particular groups of at-risk and disadvantaged youth, including those who have dropped out of school or who are likely to do so and those who live in low-income families and in poor neighborhoods. Finally, the programs include school-based initiatives to provide sex education and adolescent health services.

Although the efforts have been many and scholarly studies are replete with descriptions, the programs have produced few answers as to how to reduce the incidence of teenage childbearing or improve outcomes for teenage mothers and their children. The base for judging the efficacy of various intervention strategies is a relatively small number of demonstration and community service programs. Still, the results suggest that the most successful programs have been those that were most directive or authoritative and sent the clearest messages about right and wrong.

National Programs Providing Family Planning Services

The millions of dollars of federal money spent on family planning and reproductive health has lowered rates of infant and neonatal death, decreased fertility rates among low-income women at high risk of tightly spaced births, and reduced the incidence of low birthweight babies.³¹ Although there is no evidence that these funds have reduced teenage pregnancy rates, they may reduce the teenage birthrates by increasing the rates of abortion.³² The research also shows that sexually active teenagers are somewhat less likely to use contraceptives at their first intercourse if they live in a community with relatively high welfare benefits, perhaps reflecting the greater likelihood that areas with such benefits also may offer teenagers greater access to abortions.³³

Demonstration and Service Programs

The limited research on demonstration and service programs covers strategies ranging from promoting abstinence to providing full-service adolescent health education (with abstinence training) in conjunction with social and health services, sometimes including dispensing of contraceptives and counseling about options (table 3A-1). The most promising prevention programs are clear about which values they promote. They also offer ways to resist peer pressure to engage in sex and teach youths how to use contraceptives effectively after they become sexually active. Simply promoting abstinence does not seem especially effective, at least judging from current research. Neither Project Taking Charge, which combined abstinence education and vocational education, nor the Success Express school- and community-based abstinence initiative successfully promoted abstinence among middle school students.³⁴

Programs providing only sex education, without the focus on abstinence (Teenage Talk, Group Cognitive Behavior Curriculum, and Facts and Feelings, for example) have in some cases increased knowledge of contraceptive options and contraceptive use. But they have not succeeded in delaying the onset of sexual activity.³⁵ But programs that combine values training with sex education have shown some success. For example, the Teenage Services Program based on the Postponing Sexual Involvement model, which combines abstinence training with sex education and contraceptive education, has shown evidence of delaying the onset of t of intercourse or reduce the frequency of intercourse . . . [or whether] school-based or school-linked reproductive health services, either by themselves or in addition to education programs, significantly decrease pregnancy or birthrates."³⁷

Only one of the programs studied, the Self-Center, a full-service health education and counseling program offered through a community-based, school-linked health clinic, showed signs of delaying sexual involvement and improving contraceptive use.³⁸ It also appears that compared with the other program models, this one placed greater emphasis on values and used a more directive approach in helping teenagers make wiser choices.

The Quantum Opportunities program, a mentoring and enrichment program for at-risk high school students that emphasizes values and opportunities associated with staying and doing well in school, appears to have had dramatic effects on the teenage pregnancy rate in one of its four sites, a result that will be reexamined in a larger-scale replication study.³⁹ This successful site also appeared to be the most structured and paternalistic, providing greater levels of contact between program staff and students, as well as the most structured peer and mentor support components. In contrast, programs such as the Summer Training and Education program, which combined family planning education with summer employment in a voluntary and highly supportive setting, promoted improved knowledge about contraception but have not affected pregnancy and birth outcomes among teenagers.⁴⁰

There is some promise that programs taking a more holistic approach to dealing with the social, economic, and educational needs of teenagers from at-risk families will reduce their pregnancy rates and birthrates. One of the best known, the Children's Aid Society Teenage Pregnancy Primary Prevention program in New York, offers strong reproductive health education and counseling in the context of comprehensively addressing the needs of teenagers from disadvantaged backgrounds. The program not only attempts to deal with the economic and social environments of the youths, but it also devotes considerable effort to building strong social values and decisionmaking skills that emphasize long-range goals. Although a descriptive assessment of program outcomes is encouraging, there has not yet been a rigorous evaluation of its effectiveness in preventing teenage pregnancy and parenting.⁴¹

Programs for Teenage Parents

There have been rigorous tests of only a few programs that target teenagers who already are mothers by simultaneously attempting to reduce the incidence of repeat pregnancies, increase the likelihood of high school completion and moving into higher education, and promote employment. After more than a decade of research, observers have discovered no magic formula. None of the eight methodologically sound evaluations of such programs covered in this review points to a model program for future policies.⁴² But together these studies enrich our understanding of the problems and suggest the potential of directive programs.

These eight programs represent four strategies for addressing the needs of teenage parents, albeit with overlapping features (table 3A-2). Two are youth employment and training programs that served, but did not specifically target, significant numbers of teenage parents.

—JOBSTART. This thirteen-site demonstration of education, vocational training, and support services for disadvantaged young school dropouts operated between 1985 and 1988. During this time it served about 2,000 youths between the ages of 17 and 21. About one-fourth were teenage parents. The program was evaluated using an experimental design.⁴³

—Job Corps. A federally funded program offering intensive education, training, and social services to at-risk 16- to 22-year-old school dropouts from disadvantaged backgrounds. Most Job Corps services are provided in residential centers. Job Corps centers were the focus of the most recent completed evaluation of the program conducted in the late 1970s and early 1980s. Only a small percentage of corps members (but relatively large absolute numbers) were teenage parents. The subsample of young parents for the evaluation consisted of 1,008 young women. The evaluators used a matched comparison sample study design.⁴⁴

Two programs were comprehensive education and training programs targeted on teenage parents exclusively.

—New Chance. This national demonstration of small-scale, intensive, and comprehensive service programs offered education, training, and social support services for teenage parents on welfare who had dropped out of school. Programs operated in sixteen locations in ten states between 1989 and 1992 offering services to about 1,400 young mothers for up to eighteen months. The evaluation used an experimental design.⁴⁵

—Project Redirection. This was a four-site demonstration of comprehensive services for parents age 17 or younger. The programs, which served about 300 young mothers between 1980 and 1981, were operated by community-based organizations offering education, training, mentoring, job placement, child care, family planning, and parenting training. The evaluation used a comparison-site design.⁴⁶

Two of the programs were welfare-based education and employment programs directing mandatory education and job preparation services to teenage parent welfare recipients.

—Ohio Learning, Earning and Parenting (LEAP). This ongoing program is designed to keep teenage parent welfare recipients in school through a system of financial incentives and penalties. Some counties offer special support services to facilitate staying in school, but most provide only minimal case management services. LEAP has been evaluated using an experimental design.⁴⁷

—Teenage Parent Welfare Demonstration. This was a large-scale field test of a change in welfare programs for first-time teenage parents. The programs required teenagers to participate in self-sufficiency-oriented activities to receive the maximum welfare grant. They also provided them with case management as well as education, training, employment, and social support services. More than 3,000 young mothers received services between 1987 and early 1991. The programs were evaluated using an experimental design.⁴⁸

Finally, two programs focused on health and were targeted at first-time parents, many of whom were teenagers.

—Teenage Parent Health Care Program. This was an intensive health-focused intervention for mothers younger than 17 and their infants. It provided intensive case management by trained social workers for up to eighteen months after delivery. The program served about 120 mothers and infants in the late 1980s. The demonstration was evaluated using an experimental design.⁴⁹

—Elmira Nurse Home Visiting Program. This was a demonstration of nurse home visitation services for socially disadvantaged women bearing their first child. The program served 400 women, 47 percent of whom were teenagers. It was evaluated using an experimental design.⁵⁰

These programs ranged in cost from a few dollars per person per service month (Ohio LEAP) to more than $1,500 per service month (New Chance) (table 3A-2). They not only included programs serving very small portions of the teenage parent population (Job Start, Job Corps, New Chance, Project Redirection, and the two health-focused interventions), but also those serving the universe of teenage mothers going onto welfare (Ohio LEAP and the Teenage Parent Welfare Demonstration).

The Need for Mandatoriness

For years, the prevailing view among policymakers and social service deliverers alike was to prefer voluntary programs. The idea was that public resources should be reserved for the "most motivated," who were also presumed to benefit most. But today the trend is to mandate participation. This shift in emphasis arose in part from the frustration of taxpayers who were increasingly concerned about rising welfare expenditures and in part from the ineffectiveness of unstructured programs. These forces led to the first serious testing of paternalistic policies that establish general expectations: for example, that all welfare recipients should participate in work-oriented effort or that teenage parents who have not completed high school should attend school full-time despite their parenting responsibilities.

The evidence from these trials suggests that levying such expectations is constructive for teenage mothers and their children. First, experience from the two major field tests of mandatory programs for teenage parents, the Teenage Parent Welfare Demonstration and Ohio's LEAP, demonstrates clearly that most teenage parents will not participate voluntarily in any type of education or training program. For example, of the 89 percent of recipients who participated as required in the Teenage Parent Welfare Demonstration, just under half did so after they received their first notice from the welfare department informing them of their obligation to report to the program. Another 42 percent participated after the notification by the welfare department that their grants were about to be cut by 50 percent on average if they did not report. Finally, about 7 percent participated only after their welfare grants had been reduced.⁵¹

Similar experience with front-end participation occurred in Ohio's LEAP program, which offered a $62 a month bonus if the recipient complied with school attendance and performance standards, and a $62 a month penalty if she did not (mediocre performance meant no adjustment). Less than 10 percent of the teenagers in Ohio's LEAP program were unaffected by the policy, and more than half of the teenagers received at least one sanction. Indeed, the program's effects were large and consistently significant only in the site that made the greatest use of sanctions (68 percent of all teenagers versus only 56 percent in the other sites).⁵²

In contrast, New Chance, which offered many more services but in which participation was voluntary, had enormous difficulty filling small programs even in areas that had large numbers of teenagers giving birth monthly. Participation patterns among the volunteers in these programs may look similar to those of the Teenage Parent Welfare Demonstration and the other more mandatory programs, with an average participation level of 4 hours a week (300 hours over eighteen months).⁵³ But the mandatory programs achieved this level for a much greater share of those eligible.⁵⁴

Program Effects

These programs differ widely in the teenage parents they target, program size, intensity and mix of services, setting, and cost. Three larger demonstrations—New Chance, Ohio's LEAP, and the Teenage Parent Welfare Demonstration—allow the examination of variations in effectiveness in the same program across sites and the features that might explain them.

Employment-related outcomes. Employment-related outcomes for teenage-parent populations served by these programs tended to be poor, whether or not the teenagers participated in the programs. Between one-fifth and one-third of participants engaged in any type of job training after enrolling in the programs. Between 20 and 60 percent of the young mothers were employed at some time following their program experience (the higher rates were in sites with longer follow-ups). Average earnings were less than $300 a month and were as low as $76 a month in one demonstration (New Chance), largely because of the low employment rates and part-time nature of the jobs. Not surprisingly, given the alternative of welfare support, wages among those employed tended to average $5 to $6 an hour.

The seven programs for which employment-related outcomes were measured show at best modest results, and the effects varied considerably across programs (table 3-1). In three of the four programs—New Chance, Project Redirection, and the Teenage Parent Welfare Demonstration—that

Table 3-1.Estimated Employment-Related Outcomes of Seven Welfare Programs
Percent of control/comparison group mean unless otherwise specified

Program	Monthly earnings (1995 dollars)	Job	Employment training
Estimated program impact
Job Start	n.a.	0.4	7.5
Job Corps	n.a.	-40.5 a	-44.4 a
New Chance	48.0 a	-4.9	-33.4
Ohio Learnfare	-9.3	20.0 b	7.6
Project Redirection	12.4	15.1	51.5 b
Teenage Parent Welfare Demonstration	18.6 a	11.8 a	20.0 a
Elmira Nurse Home Visiting Program	n.a.	46.8	n.a.
Participant group mean
Job Start	n.a.	49.1	260
Job Corps	n.a.	40.0 c	448
New Chance	0.3	42.6	85
Ohio Learnfare	17.5	33.2	143
Project Redirection	21.8	60.1	436
Teenage Parent Welfare Demonstration	26.8	48.2	108
Elmira Nurse Home Visiting	n.a.	21.0 d	n.a.

Sources: See appendix table 3A-1. Data for the Job R

Table 3-2.Estimated Education-Related Outcomes of Seven Welfare Programs
Percent of control/comparison group mean unless otherwise specified

Program	High school enrollment	Received diploma/GED	Measured	Received basic GED skills
Estimated program impact
Job Start	n.a.	57.3a	67.1 a	n.a.
Job Corps	-80.3a, b	666.7 a	n.a.	n.a.
New Chance	84.9 a	43.7 a	74.9 a	< 0.1
Ohio Learnfare	15.5 a , c	6.6	32.1	n.a.
Project Redirection	16.7	0.1	n.a.	n.a.
Teenage Parent Welfare Demonstration	42.0d	4.0e	19.2	< 0.1
Teenage Parent Health Care	< -0.1	n.a.	n.a.	n.a.
Elmira Nurse Home Visiting	-45.2d	n.a.	n.a.	n.a.
Participant group mean
Job Start	n.a.	42.0	39.1	n.a.
Job Corps	6.6 f	6.3 f	n.a.	n.a.
New Chance	33.0 f	43.1	36.8	7.8
Ohio Learnfare	67.4	34.0	11.1	n.a.
Project Redirection	18.6	48.3	n.a.	n.a.
Teenage Parent Welfare Demonstration	41.6	48.4	5.7	8.1 g
Teenage Parent Health Care	55.6	n.a.	n.a.	n.a.
Elmira Nurse Home Visiting	62.0 d	n.a.	n.a.	n.a.

Sources: See table 3-1.

n.a. Not available. a. Statistically significant at the 5 percent level. b. Months 0_6 after enrollment. c. Continued through tenth month postpartum.

d. Measured in grade equivalent scores. e. Statistically significant at the 10 percent level. f. Percent of time. g. Measured 18 months after enrollment.