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School-Based Health Services Lead to Decline in Teenage Pregnancies and Save More Than $30 Million in New York City, Says Study Co-Authored by Baruch College Provost James McCarthy



Findings from nearly a decade’s worth of data as U.S. continues to have the highest rates of teenage pregnancy and birth among developed countries

The availability of comprehensive contraceptive services through the School-Based Health Center Reproductive Health Project (SBHC RHP) in New York City resulted in a substantial decline in teenage pregnancies, births, and abortions over a decade and, in turn, saved the city and state more than $30 million in related Medicaid and public insurance costs.

These are among the findings of a major research study just published in Perspectives on Sexual and Reproductive Health (PSRH) by Rebecca Fisher, Phoebe Danza, and Lorraine Tiezzi, all of the New York City Department of Health and Mental Hygiene’s Office of Adolescent Health, and James McCarthy, PhD, Interim Provost and Senior Vice President for Academic Affairs at Baruch College.

Making Highly Effective Birth Control Available Averts Teen Pregnancies

The availability of a wide array of contraceptive services at school-based health centers in New York City, from 2008 to 2017, averted an estimated 5,376 pregnancies, as well as 2,140 births and 3,085 abortions. Most dramatically, 14 percent of students in SBHC RHP used the most effective contraceptives: long-acting reversible contraceptives (LARCs), which include injections, subdermal implants, and IUDs. Use of LARCs among students in non-RHP schools was 2 percent. 

The very high effectiveness rates associated with LARCs was an important component of the overall impact of the RHP. The authors estimate that the pregnancies averted through the SCHC RHP account for 26 to 28 percent of the overall declines in teenage pregnancies, births, and abortions recorded in the years when the reproductive health project was in place.

Reducing Teen Pregnancies Saved More Than $30 Million

Furthermore, the one-time costs avoided for publicly funded births and abortions is estimated at $30.3 million. These costs are based on estimates of the immediate pubic costs of providing care—largely through Medicaid—for childbirth and abortion services. However, the total cost savings over time is likely much higher, because the study did not estimate the costs avoided for ongoing medical care, public assistance, or entitlement programs for the mother or the child.

“This paper confirms the results of many studies that show that providing effective contraceptives to adolescents—in school and community settings—can contribute to lower pregnancy, birth, and abortion rates,” said Dr. McCarthy. “Our ability to examine the particular impact of long-acting reversible contraceptives over the past decade, in school-based clinics, is arguably the most important finding in the paper.”

“We need to also remember that the impacts we observe set the stage for impacts throughout the lives of the young women we’ve studied,” Dr. McCarthy continued. “Decades of research on the long-term consequences of adolescents’ access to appropriate contraceptive healthcare and effective sexual education directly contribute to students’ social mobility and their ability to stay in school.”

“This positive result helps clear the way for these students to continue their studies at higher education institutions or post-secondary schools.”

The paper appears in the December issue of PSRH, a peer-reviewed journal published by The Guttmacher Institute, a leading research organization that studies, educates, and works to advance sexual and reproductive health and rights, in partnership with Wiley-Blackwell. Read the full study here.

Distinguished Career for James McCarthy, PhD

The paper represents the latest accomplishment in McCarthy’s notable career in academia and demographic and public health research. A number of his research publications have appeared in Perspectives over the years, including his first series of Perspectives papers that were published 40 years ago—in 1979. Currently serving as Interim Provost and Senior Vice President for Academic Affairs at Baruch, Dr. McCarthy is also a distinguished lecturer at the College’s Marxe School of Public and International Affairs.

He has held senior faculty and leadership positions at Johns Hopkins, Columbia, the University of New Hampshire, and Baruch, where he served as Provost and Senior Vice President for Academic Affairs from 2007 to 2012. Dr. McCarthy also served as president of Suffolk University, and as a consultant for strategic planning and academic technology at universities throughout the United States.

Dr. McCarthy has conducted demographic and public health research in the United States, Europe, Latin America and the Middle East, and has published extensively in leading journals in a number fields.

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 (Story published on 12/19/19)

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