Interview: Sarah S. Brown

Article excerpt

Sarah S. Brown is director of the National Campaign to Prevent Teen Pregnancy, a nonprofit, non-partisan initiative she helped created in 1996 to improve the well-being of children, youth, and families by reducing teen pregnancy. As she explains in the following interview, the campaign played a critical role in a remarkably successful effort that reduced by one-third the number of pregnancies and births among teenage girls. This experience can serve as a model and an inspiration for other public health programs.

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A specialist in women's and adolescent health, Brown has worked in the public health sector for more than 30 years. Before cofounding the campaign, she served as senior study director at the Institute of Medicine, where she directed a range of maternal and child health projects, including The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families, a widely cited study of the probable causes, effects, and possible remedies of unintended pregnancy. Brown has served on the boards of the Alan Guttmacher Institute and the District of Columbia's Mayor's Advisory Board on Teenage Pregnancies and Out-of-Wedlock Births. She is the recipient of numerous awards, including the Irvin M. Cushner Lectureship Award from the Association of Reproductive Health Professionals, the Institute of Medicine's Cecil Award for Excellence in Research, and the Martha May Elliot Award of the American Public Health Association.

Why was the National Campaign to Prevent Teen Pregnancy organized, and what made you think this progress was possible?

The National Campaign to Prevent Teen Pregnancy was organized in 1996 by a diverse group of individuals who had concluded that the problem of teen pregnancy was not receiving the intense national focus that it deserved; that too few Americans understood the central role that teen pregnancy plays in child poverty, out-of-wedlock childbearing, and welfare dependence; and that there was merit in raising the profile of this problem and in pushing hard for solutions. At its first meeting, the National Campaign's board defined the organization's mission: to improve the well-being of children, youth, and families by reducing teen pregnancy. The board also set a numerical goal for the nation and the National Campaign: to reduce the rate of teen pregnancy by one-third between 1996 and 2005.

Most observers considered this goal--to put it charitably--overly ambitious. Because rates of teen pregnancy spiked upward during the mid- and late-1980s, there were many who felt that this nation's high rates of teen pregnancy were inevitable and intractable. Our reading was a bit different. Taking a longer view, we saw that rates of teen pregnancy and birth had been declining slowly but steadily (more or less) for over two decades, with the exception of this late-1980s blip. Consequently, we believed that teen pregnancy rates could again start heading in the right direction, provided that the issue received the national attention it deserved.

What strategy has the National Campaign used?

The National Campaign's strategy is based on a straightforward concept: Reducing teen pregnancy can be accomplished only by fewer teens being sexually active and/or by better use of effective contraception among those who are. Both behaviors contributed to earlier declines in teen pregnancy, and more of both are needed in going forward to sustain the decline. All of the National Campaign's efforts center on affecting these two behaviors by communicating directly with teens themselves or by influencing intermediaries that research has shown influence the sexual behavior of teens.

The organization's strategy works on two main fronts: building a more coordinated and effective grassroots movement in states and communities and influencing social norms and popular culture. In all of our work, we engage a range of sectors--teens, parents, state and community leaders, entertainment media executives, educators, faith leaders, policymakers, the press, other national nonprofit groups, and more. …