Three Strategies to Prevent Unintended Pregnancy

Abstract

This paper presents results from fiscal impact simulations of three national-level policies designed to prevent unintended pregnancy: A media campaign encouraging condom use, a pregnancy prevention program for at-risk youth, and an expansion in Medicaid family planning services. These simulations were performed using Fam-ilyScape, a recently developed agent-based simulation model of family formation. In some simulation specifications, policies' benefits are monetized by accounting for projected reductions in government expenditures on medical care for pregnant women and infants. In a majority of these specifications, policies' fiscal benefit-cost ratios are less than 1. However, in specifications that account additionally for projected savings to programs that provide a broader range of benefits and services to young children, all three policies have benefit-cost ratios that are comfortably greater than 1. The results from my preferred specifications suggest that the simulated policies would produce returns to taxpayers on each dollar spent of between $2 to $6. On the whole, the results of these simulations imply that all three policies are sound public investments. C 2012 by the Association for Public Policy Analysis and Management.1 On the share of pregnancies that are unintended, see Finer and Zolna (in press). 2 Information on the marriage rates of women who experience intended and unintended pregnancies is taken from unpublished tabulations of data gathered by the Guttmacher Institute. For a survey of

Benefit–cost analysis of a randomized evaluation of Communities That Care: monetizing intervention effects on the initiation of delinquency and substance use through grade 12

“…However, economic information often is needed more immediately to determine the potential benefits of investing in specific interventions (Lee and Aos 2011; O'Connell et al 2009; Pew Center on the States 2012). Long-term projection models of economic benefits can help meet this need (Kahn et al 2010; Lee et al 2012a; Thomas 2012). The reliability and validity of projected estimates are enhanced by strong research designs and high-quality models (Welsh and Farrington 2000).…”

The role of mass media campaigns in preventing unintended pregnancy

“…Moreover, because the simulated media campaign has the ability to reach a large number people relatively cheaply, it is found that its costs per pregnancy and birth averted are generally lower than are those of these other programs. See Thomas (2012) for more information on all three simulations.…”

“…These taxpayer-savings estimates account for government spending on pregnant women and on children up to age five; and they are adjusted to reflect the fact that some prevented pregnancies will simply be delayed whereas others will be averted altogether. See Thomas (2012) and Monea and Thomas (2011) for additional information on the way that these savings estimates were developed.…”

“…Rigorous evaluations have found many of these programs to be effective at achieving this goal (Sawhill et al, 2010;Thomas, 2012). However, because most teens are in school while most young adults are not, it is much more difficult to reach members of the latter group than of the former group via these sorts of place-based interventions.…”

Cost Analysis of an Adolescent Pregnancy Prevention Program In-School Model Site

“…This study found that, from a societal perspective, every dollar invested in the program resulted in a savings of $2.65 in medical and societal costs (in 1994 dollars, and $4.24 in 2015 dollars) that included earnings and public assistance. Thomas (2012) used a modeling-based approach to examine the cost-benefit of a hypothetical teenage pregnancy prevention program based on outcomes from five evidence-based teenage pregnancy prevention programs in the United States. He estimated that from the perspective of the government, every dollar invested in teenage pregnancy programs results in $2.46 savings (in 2008 dollars, and $2.71 in 2015 dollars) from pregnancy care, infant medical care, and public assistance for children through age 5 (Thomas, 2012).…”