United Way of Greater Milwaukee: Preventing Teen Pregnancy
A study released this fall in the American Journal of Public Health looks at a critical evidence-based teen pregnancy prevention program led by the United Way of Greater Milwaukee. The United Way catalyzed critical partnerships between schools, community organizations and the Milwaukee Health Department to focus on the goal of reducing teen pregnancies.
In 2008, United Way of Greater Milwaukee, together with its partners, made a public commitment to reduce teen births among 15- to 17-year-olds by 46 percent by 2015. In October 2011, the City of Milwaukee and United Way announced the fourth consecutive yearly drop in the teen birth rate, by 13.5 percent, to its lowest level in decades. The current trend indicates that the partners are on track to reach their goal of 30 births per 1,000 (a 46 percent drop) by 2015.
Initiatives to support these goals include:
- Significant investments in programs through the Healthy Girls project that helps young people understand the consequences of teen pregnancy while also teaching them the skills needed to cope with social pressure to engage in sexual activity.
- A collaboration with the Medical College of Wisconsin and Children's Hospital of Wisconsin residents to develop content for a youth-focused, website, Baby Can Wait, with medically accurate and age-appropriate content on preventing pregnancy and promoting healthy relationships.
- United Way worked with Milwaukee Public Schools and other community leaders to revise human growth and development curriculum. Community members were given an opportunity to review the materials and make suggestions about content, and teachers received training in the new curriculum.
NewPublicHealth caught up with Nicole Angresano, Vice President at United Way of Greater Milwaukee, to get her take on the program’s successes and what other communities can learn from them.
NewPublicHealth: What is different about this effort to focus on teen pregnancy for your community?
Nicole Angresano: One of the things that separates this initiative and makes us successful is the diversity of the roles and the acknowledgement that one strategy is not going to fix this problem. We realized very early on that we needed to be inclusive and diverse and considerate of broad opinions and beliefs while still staying true to those methods and strategies that had science based-evidence.
NPH: Who were those critical partners?
Nicole Angresano: We have an advisory council of community leaders that drove this initiative from the start and that group is quite diverse. It includes government leaders, such as the mayor, the commissioner of health, leaders of the business community, the local school system and community based organizations.
The Milwaukee Public School System early on partnered with us to make sure that kids started learning about health and their bodies at a very young age because you can’t wait until kids are 16 to talk about that and hope that it’s going to take hold.
A second core group at the table, which might be unexpected, is the faith community. And we have found that faith-based organizations really play a critical role in public health initiatives. From the very beginning we had a faith-based committee that looked at ways that faith leaders of different denominations could impact our strategies and goals. One of the first things that we did was to implement faith-related curriculum at church meetings. For example, we worked with the Black Church Initiative out of Washington, DC, and implemented a curriculum called Keeping it Real, which is a Christian-based prevention program. While it is not as bold or exhaustive as the more traditional sex-ed comprehensive curriculum, it is certainly a big step in terms of meeting people where they are. Not every family and not every setting is ready to embrace comprehensive sex-ed fully, so we felt like this was a great opportunity to start where people are in their journey.
NPH: How do you get consensus among all of these different partners with very different perspectives, but then also come back to where the science lies and what’s evidence based?
Nicole Angresano: What we have done from the beginning and have continued to do is provide the community with objective information and education. Before we can expect people to embrace our initiative, there has to be awareness that the situation or problem exists and we need to do our due diligence to make sure people have good information. One of the great partnerships we have enjoyed during these past six years is with our local paper, the [Milwaukee] Journal Sentinel, which has really done an extraordinary job keeping this issue front and center with both editorial and news content. As you increase your community’s awareness of and comprehension of the problem, you are going to be more successful in the long term in terms of first of all getting the community on board and then really impacting change.
We only have one goal in this initiative and that is to reduce birth to teens by 46 percent by 2015. The strategies and pathways that lead to that goal are very diverse and I think there’s room for everyone within the initiative. So not everyone as you might suspect embraces the idea of comprehensive sex education but they understand that in order to build a successful business, for example, you have to live in a community that is safe and not perceived as being violent or impoverished. We did a good job showing the evidence that linked teen birth and pregnancy to poverty and so they were able to acknowledge that relationship and invest accordingly.
From a personal standpoint I wish that we cared about this issue as a matter of social justice—that we all embrace it because we don’t think that teenagers should have their lives determined for them when they turn 15. But that’s not what resonates with everyone and that’s not where everyone is coming from so we try very hard to build a case that was more rational and less emotional and really just illustrate for people: here are the facts, here is what the cost is, both social and financially, to a community that experiences a high level of teen pregnancy and teen births. Here is why we believe very strongly that we need to do something about it and here are the multiple strategies that we believe will positively impact this situation.
NPH: What role has the health department played?
Nicole Angresano: Bevan Baker, Milwaukee’s Commissioner of Health has been the chair of our oversight committee. His leadership and his credibility have been enormous assets to us. We work very closely with the Health Department to ensure that our strategies are aligned. We have provided in the past funding for programs within the Health Department that were specific to reducing teen birth, for example, condom availability programs. And one of the mechanisms we have to do that is our Collaborative Fund, a really unique piece of this initiative. The Collaborative Fund represents a group of corporate and private foundations who have pooled at least 50 thousand dollars each and then make funding decisions as a collective group. So we currently have 9 members and access to about 450 thousand dollars a year that we use invest in proven strategies, including supporting the Health Department.
NPH: What has the progress been so far?
Nicole Angresano: The progress has been extraordinary. The key metric that we look at each October is the teen birth rate. And for five consecutive years that rate has gone down. And it has gone down dramatically. So although the national rate is now going down as well, which is a wonderful thing, as a community over the past 5 years we’ve outpaced national numbers and we are very confident that we are going to reach that 46 percent reduction by 2015—a rate that is really unprecedented in terms of a community in setting a goal for success.
NPH: Have you gotten requests from other communities for guidance on reducing their teen pregnancy rates?
Nicole Angresano: We get a lot of requests from communities asking us to send the model. I am always very happy to share our work and to work with communities, but also I also offer a cautionary tale which is that this is a Milwaukee initiative, and it is based in Milwaukee’s needs and Milwaukee’s culture and Milwaukee’s history. It is not nor has it been intended to be a one size fits all coalition or collaboration that you can simply pick up and drop into Toledo or Chapel Hill or Washington, DC. Being good public health students we try very hard to make sure that the individual nature of communities has to be respected and has to be acknowledged if an initiative such as this is going to work and there are pieces here that may not work in other places. Then there are some pieces here that I think may easily be replicable. So I think it varies by strategy.