welcome to "viewpoint." i'm pat lawson muse. the d.c. campaign for teen pregnancy with a move to cut teen pregnancy in half. this morning we talk about the problem and progress. my guest, chair of the d.c. chapter of adolescent working group for american academy of pediatrics. brenda rhodes miller is executive director of the d.c. campaign to prevent teen pregnancy. aurora munoz is with the young women's project here in washington. thank you, all of you, for being with us. >> thank you. >> brenda let's start with you. in recent decades teen pregnancy

rate has fallen dramatically here and across the country. what is the situation here in washington and how close are you to reaching the goal? >> we're delighted the teen preg nanny rate is at the lowest level in years, 49.4 pregnancies per 1,000 girls 15 to 19 well on the way to reaching the captain. double dinl pregnancy rate isn't good enough for the capital and we would like to reduce teen pregnancy even more. >> what do you think has been the key in getting the numbers down as far as they are. >> i think krishna and aurora and other organizations in the city have worked together. we've had the goal of cutting in half together. we've worked with research-based interventions. we've engaged parents. we're talking to the media like we're talking to you now. we've listened to teens so we could continued find out what's

important to them about making the decisions whether or not to have sex. >> aerror ark, what did they say is the biggest factor to them. >> teens need access to resources. they make the decisions they are going to make but they need ways to stay safe and prevent pregnancy for themselves. that's what they really want is to have that confidential and teen friendly services available to them. >> doctor what would you say is the primary factor in whittling that number down mostly fair i think what we've seen from research both nationally and locally, probably the single biggest chunk of the decline has come from improved use of contraception among adolescents. that's something that has taken place across the country as well as in the district of columbia. there has been some redux teens starting to have sex in the teen years. that's been a smaller proportion

of the decline rather than the use of contraception. >> brenda you did a study that showed rates in the city were falling except in pockets east of of the river. >> we know it's dlipd but teen births has dropped dramatically. it's down to 790. of thought 790, half are in ward 7 and 8. when you add in ward 5 that accounts for three-quarters of all the teen births in the city. >> what are your strategies for targeting the resistance to the improvements in those areas. >> one thing we know teens make the decision to postpone having sex or use contraception, based on whether they have any motivation. motivation comes from having good schools and being able to get teen friendly health care aurora talked about, having a sense of belonging, having a plan for their future that

doesn't include becoming a parent having a close caring relationship with a trustworthy adult. so those protective factors have to be increased in the neighborhoods where the numbers have not decreased. >> doctor research shows social disadvantages are a huge role here as far as risk factors are concerned including how well kids doin' school and where they live? >> uh-huh. yes, i think that's true. you know as teen pregnancy along with other health conditions we see a the lo of health disparities within the rates. i think there's certain communities such as the ones you mentioned in the district east of the river youth and adults facing many disadvantages in terms of employment opportunities, access to quality education as well as access to health services. i think all of those things really contribute. what i'd like to add to what brenda said if you think about all those things it's really a

multi-pronged approach that's needed. one of the things our academy, district chapter of american academy of pediatrics has done is really try to say what can we do to help support other community groups physicians such as pediatricians members of our organization but also groups like brepd, a's who have been working decades to reduce teen pregnancy as well as the young woman's project in other groups to really come together to think about multiple strategies that can really target these rates. >> and those strategies have to target hispanic and african-american girls, don't they aurora? >> with other program, we do try to target teens that are representative in their schools, african-american and latino women. especially we've found latinos tend to have a higher percentage of teen pregnancy, this is from many issues. one is they are the most uninsured people in the district and they have access to some of these services.

>> all right. we're talking about teen pregnancy in the district of columbia and this region. stay with us. we'll be right back. dude totino's blasted rolls. sweet. totino's blasted crust rolls... yeah. flavor at full blast you say avocado old el paso says... zesty chicken and avocado tacos in our stand 'n stuff tortillas . (record scratch) you say stand n' stuff tortillas old el paso says... start somewhere fresh

welcome back. we're talking about teen pregnancy this morning. doctor how does the washington region deal with teen pregnancy? is there a regional approach? >> i would say there's not necessarily a regional approach because we have different jurisdictions that have different policymakers and different policy structures but a number of us work collaboratively across the region. so i am on the faculty at john hopkins school of medicine and do a lot of research and follow

a lot of research and i'm able to share with my partners in my home community and district. will as part of the working group, we have gotten information from our partners in maryland of the ways they have tackled, for example, reimbursement for the most effective methods of contraception and we've been able to share that with our d.c. council, legislators as well as with our community partners. so i think there are ways we share knowledge, but we each unfortunately have to work within our own communities with the policymakers we have. >> brenda regardless of where it happens, a lot of the issues are the same whether talking about teens in d.c. maryland or virginia unemployment broken families social services. those are all factors that contribute to this problem, aren't they? >> unemployment generational poverty, neighborhoods with few opportunities for recreation or for employment for teens. when you look at the demographic

data that is true of neighborhoods with high numbers of teen birth, it's pretty consistent across the region. so we get technical assistance from our partners in other communities and we offer technical assistance. we've worked with alexandria prince george's. it would be great to have a regional approach but i'm not sure we have regional approaches on many issues that are well coalesced yet. >> aurora one of the city's solution is young women's project that you work with. tell us exactly what you do. >> so at the young women's project i train and recruit teens throughout the city to become teen educators and condom distributors in schools. they help with policy and advocacy so they have been fighting for comprehensive sexuality in their schools to change that health education standard so they better reflect what d.c. teens need in reproductive health but also all

health areas. and we've also been working to make sure that community resources are teen friendly and confidential. >> and your program focuses on teens and foster teens. >> the other branch of the young wimgs women's women who for whatever reason don't have housing, those are disproportionately with teen pregnancy, so we've helped with that as well. >> there was a time when it was believed sex education would help not solve the problem but help to address it most efficiently. how has sex education evolved and how effective is it? how has it changed? >> i think it's a good question. youth need to know about sex. sex education from that standpoint is extremely

important. i think what we know is there are a variety of qualities of health education that are out there. sometime the ones that are available to students in schools are not always the most effective. they are not always evidence-based. so i think over time our national policy has supported abstinence until marriage which we know is not effective reducing teen sexual risk as opposed to comprehensive sexuality education, which can be extremely effective. so i think we have to -- when we talk about health education, i think it is important but i think we have to make sure what we're giving is medically accurate. that's not always the case. >> brenda it's not enough today to warn teens about stds or pregnancy or give them condoms. >> d.c. campaign has trained 3,000 parents and other adults about how to talk to their children about love sex, relationships and values because teens want to hear from their

parents about sex, even though it doesn't look like that all the time. >> that's a difficult conversation for a parent to have. >> it can be a difficult conversation. we help parents see if you're sitting there watching television with your children and some scene comes on it's a perfect opening, what do you think about that? why do you think they didn't talk about sex before they jumped in bed together? you have the conversation. it isn't one-time conversation. have you to talk to your children from the time they hear until they leave the house. it's a lifelong conversation and lifelong learning opportunity. >> if i could also echo the importance of that. i think one of the things we know we focus on the high-risk use with a lot of social disadvantages but we have to come to recognize, most adolescents, most teens will start having sex before 20 if you look at national data. helping youth to get positive information about what we want that to look like is really important and parents play a

critical role. >> got to take a break. we'll be right back. dude totino's blasted rolls. sweet. totino's blasted crust rolls... yeah. flavor at full blast you say avocado old el paso says... zesty chicken and avocado tacos in our stand 'n stuff tortillas . (record scratch) you say stand n' stuff tortillas old el paso says... start somewhere fresh

welcome back. we're talking about teen pregnancy, reducing teen pregnancy in the city. brenda brenda you're talking about the role how critical it is and how you work with parents. i'll ask all of you this how do you address the issue with teen parents themselves. there are so many teens who are parents and so many young parents that never learned the lessons themselves. how do they teach their kids. >> that's a really good point. the research shows if you're the child of a teen parent is more likely to be a teen parent themselves. you know as a fully grown adult with a fulltime job and a partner, it's hard for me to

raise kids in the district so i can't imagine how hard it is for those young single moms to do it. so i think it's a critical thing. just the work brenda has done over the years that has reduced the rate that work on its own is kind of going to be contributing to the next generation of reductions. >> aurora what do you think about that? >> i think teen parents need the information that -- to pass down to their kids starting early. we do it through peer education. we do focus on building healthy relationships, not just romantic relationships but relationships with your friends, with your children if you have them. you know i think that starting -- decreasing teen parents will eventually yeah have a decrease in the overall teen pregnancy rate. >> it's a tough thing to do isn't it? >> it is. there are a number of -- there are a couple of really good

programs in the city that work with teen parents. they provide wrap around services. they help mothers and fathers graduate from high school they provide health care they provide contraceptive services they have job club. can we mention their names? >> sure if you would like to. >> there's healthy generations program at children's national medical center. there's teen alliance for prepared parenting at washington hospital center and there's new heights, which works in d.c. public schools. all of them provide intensive services for teens who are already parents. >> that's good information. doctor you advocate the use of long-term reversible contraception like iuds. why? why do they work better? >> i think they work better because you don't have to think about them once they are placed. so any one of us has difficulty if there's something we have to remember to do every day. one of the things we know about teens, they have a lot of stable

relationships but they are not always long-standing relationships. a lot of the teens i see in my practice they are in a stable relationship today, they are not in it tomorrow. they are in one again the next day. so if they are changing -- trying to start and stop contraception within that time period it oftentimes is a recipe for failure. the one thing i would say, i think they can be a great choice. i think it's up to each individual woman to make the choice about what's best for them but i definitely think it's something that should be available to them. >> is there any indication that more teen girls are using iuds? >> absolutely yes. just last week new data national survey of family growth title 10 programs federally that showed an increase from the last survey from about 0.4 to 7% very large increase but still only 7%. so you can imagine that's 93% that are not using those methods so we still have a long way to

go. >> brenda last year the d.c. campaign convinced city council to pass teen pregnancy prevention fund establishment act. what does that do? >> it wasn't just d.c. campaign coalition of the adolescent working group, groups like young women's project and a number of other programs throughout the city to ask the city to replace the funding that would be lost when a foundation ceased funding and teen pregnancy prevention work. we didn't want to see it go up. we wanted to see it go down. the $2 million replaced that funding. it will keep many local programs moving forward as we try to double down on the neighborhoods where the number of teen births remain high. the teen pregnancy prevention fund establishment act was led by councilman alexander chair of the committee on health and now chairman of the committee of health and human services and we're hoping it will be refunded

for another year so we can maintain the work we're doing and increase the work that needs to be done to further cut the rate in half. >> all right. we'll continue our talk about teen pregnancy in just a moment. dude totino's blasted rolls. sweet. totino's blasted crust rolls... yeah. flavor at full blast you say avocado old el paso says... zesty chicken and avocado tacos in our stand 'n stuff tortillas . (record scratch) you say stand n' stuff tortillas old el paso says... start somewhere fresh

welcome back. brenda reducing teen pregnancy not only contributes to healthier communities and societies, it also research shows, can reduce child abuse and crime. can you talk about that? >> well we know that locally, we had some local data from child welfare agency. at one point 76% of the children

in the child welfare system had been born into families started by teens. so if you reduce the number of teen families families started by teens, that means you're going to have fewer children who will be abused and neglected. it isn't because teens don't want to be good parents, i'm sure that they do. as we were saying earlier, being a parent is a really hard job. it's the hardest job i've ever had. if you're 15 16 17 and you have one or more children and you don't have a stable partner, don't have a steady job, have you a housing situation that may or may not be there when you need it and you don't have any steady transportation that's a lot of stress for anyone. imagine how much stress it is for someone who is really young. you lash out. >> aurora i read a story published last year where teens in certain communities said because neither they nor their friends expected to go to

college or have careers that all they could think about really was sex. what do you think it takes to turn take kind of thinking around? >> i'm interviewed by the teens as part of my job when i first was hired. my first question they asked me was do you want a boy or a girl the first time you have children. i was shocked that was the kind of question they would ask me because they are all thinking about having children already. it seems like very few youth understand what it takes to go to college and what it takes to succeed. so that's something we're trying to instill in them. not only am i providing sexual health information but also telling them about education. we make goals, we make plans. i think that's what needs to happen. we need to see from their tarting point now in high school to college what all that takes.

i think that is really important. >> if i can add to that i think we have to think about what are the opportunities we have for praising youth for the positive things they do that are not having a child. as a pediatrician i have visited parents in the nursery. i can think of saying congratulations for your baby. of course you're going to say that to a teen mom or an older mom. we want to make sure those teens can get praised for other things they do as well. >> excellent point, doctor. thank you all for joining us. thank you for being with us on "viewpoint." stay with us for "news 4 today."

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protests quickly escalate to violence and destruction in baltimore. clashes with police lead to arrests. orioles fans warned to stay inside the park. a 7.2 magnitude earthquake rocked and killed thousands. now there's an international aid effort including a group from northern virginia on their way now. >> but first developing this morning fairfax county firefighters continue to battle a blaze at an alexandria hotel. take a look. we just got this video into the newsroom here. firefighters tell us 30% of that hotel is destroyed. the electrical fire