The House will vote this morning on an amendment to the health reform bill that if passed will effectively ban private insurance plans from providing coverage for abortion care.
Where does your rep stand?
Though boys and young men are often an afterthought in discussions about reproductive and sexual health, two recent studies make the case that they are in need of such knowledge and that it may predict when and how they will parent.
It’s easy to understand why so many programs and resources to prevent teen pregnancy and sexually transmitted infections (STIs) focus on cisgender young women: They are the ones who tend toget pregnant.
But we cannot forget that young boys and men also feel the consequences of early parenthood or an STI.
I was recently reminded of the need to include boys in sexual education(and our tendency not to) by two recent studies, both published in the Journal of Adolescent Health. The first examined young men’s knowledge about emergency contraception. The second study found that early fatherhood as well as nonresident fatherhood (fathers who do not live with their children) can be predicted by asking about attitudes toward pregnancy, contraception, and risky sexual behavior. Taken together, the new research sends a powerful message about the cost of missed opportunities to educate boys.
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The first study was conducted at an adolescent medicine clinic in Aurora, Colorado. Young men ages 13 to 24 who visited the clinic between August and October 2014 were given a computerized survey about their sexual behavior, their attitudes toward pregnancy, and their knowledge of contraception. Most of the young men who took the survey (75 percent) had already been sexually active, and 84 percent felt it was important to prevent pregnancy. About two-thirds reported having spoken to a health-care provider about birth control other than condoms, and about three-quarters of sexually active respondents said they had spoken to their partner about birth control as well.
Yet, only 42 percent said that they knew anything about emergency contraception (EC), the only method of birth control that can be taken after intercourse. Though not meant to serve as long-term method of contraception, it can be very effective at preventing pregnancy if taken within five days of unprotected sex. Advance knowledge of EC can help ensure that young people understand the importance of using the method as soon as possible and know where to find it.
Still, the researchers were positive about the results. Study co-author Dr. Paritosh Kaul, an associate professor of pediatrics at the University of Colorado School of Medicine, told Kaiser Health News that he was “pleasantly surprised” by the proportion of boys and young men who had heard about EC: “That’s two-fifths of the boys, and … we don’t talk to boys about emergency contraception that often. The boys are listening, and health-care providers need to talk to the boys.”
Even though I tend to be a glass half-empty kind of person, I like Dr. Kaul’s optimistic take on the study results. If health-care providers are broadly neglecting to talk to young men about EC, yet about 40 percent of the young men in this first study knew about it anyway, imagine how many might know if we made a concerted effort.
The study itself was too small to be generalizable (only 93 young men participated), but it had some other interesting findings. Young men who knew about EC were more likely to have discussed contraception with both their health-care providers and their partners. While this may be an indication of where they learned about EC in the first place, it also suggests that conversations about one aspect of sexual health can spur additional ones. This can only serve to make young people (both young men and their partners) better informed and better prepared.
Which brings us to our next study, in which researchers found that better-informed young men were less likely to become teen or nonresident fathers.
For this study, the research team wanted to determine whether young men’s knowledge and attitudes about sexual health during adolescence could predict their future role as a father. To do so, they used data from the National Longitudinal Study of Adolescent Health (known as Add Health), which followed a nationally representative sample of young people for more than 20 years from adolescence into adulthood.
The researchers looked at data from 10,253 young men who had completed surveys about risky sexual behavior, attitudes toward pregnancy, and birth control self-efficacy in the first waves of Add Health, which began in 1994. The surveys asked young men to respond to statements such as: “If you had sexual intercourse, your friends would respect you more;” “It wouldn’t be all that bad if you got someone pregnant at this time in your life;” and “Using birth control interferes with sexual enjoyment.”
Researchers then looked at 2008 and 2009 data to see if these young men had become fathers, at what age this had occurred, and whether they were living with their children. Finally, they analyzed the data to determine if young men’s attitudes and beliefs during adolescence could have predicted their fatherhood status later in life.
After controlling for demographic variables, they found that young men who were less concerned about having risky sex during adolescence were 30 percent more likely to become nonresident fathers. Similarly, young men who felt it wouldn’t be so bad if they got a young woman pregnant had a 20 percent greater chance of becoming a nonresident father. In contrast, those young men who better understood how birth control works and how effective it can be were 28 percent less likely to become a nonresident father.9:45]
Though not all nonresident fathers’ children are the result of unplanned pregnancies, the risky sexual behavior scale has the most obvious connection to fatherhood in general—if you’re not averse to sexual risk, you may be more likely to cause an unintended pregnancy.
The other two findings, however, suggest that this risk doesn’t start with behavior. It starts with the attitudes and knowledge that shape that behavior. For example, the results of the birth control self-efficacy scale suggest that young people who think they are capable of preventing pregnancy with contraception are ultimately less likely to be involved in an unintended pregnancy.
This seems like good news to me. It shows that young men are primed for interventions such as a formal sexuality education program or, as the previous study suggested, talks with a health-care provider.
Such programs and discussion are much needed; comprehensive sexual education, when it’s available at all, often focuses on pregnancy and STI prevention for young women, who are frequently seen as bearing the burden of risky teen sexual behavior. To be fair, teen pregnancy prevention programs have always suffered for inadequate funding, not to mention decades of political battles that sent much of this funding to ineffective abstinence-only-until-marriage programs. Researchers and organizations have been forced to limit their scope, which means that very few evidence-based pregnancy prevention interventions have been developed specifically for young men.
Acknowledging this deficit, the Centers for Disease Control and Prevention and the Office of Adolescent Health have recently begun funding organizations to design or research interventions for young men ages 15 to 24. They supported three five-year projects, including a Texas program that will help young men in juvenile justice facilities reflect on how gender norms influence intimate relationships, gender-based violence, substance abuse, STIs, and teen pregnancy.
The availability of this funding and the programs it is supporting are a great start. I hope this funding will solidify interest in targeting young men for prevention and provide insight into how best to do so—because we really can’t afford to forget about the boys.
Sen. Ted Cruz (R-TX) falsely blamed the Affordable Care Act for keeping “single moms” in part-time jobs, ignoring his own opposition to policies that could actually help single parents living in poverty.
Sen. Ted Cruz (R-TX) falsely blamed the Affordable Care Act (ACA) this week for keeping “single moms” in part-time jobs, ignoring his own opposition to policies that could actually help single parents living in poverty.
Speaking at a campaign rally Monday in Las Vegas, Nevada, ahead of the state’s Republican primary, Cruz suggested that the ACA has worked as a barrier to keep single mothers from working full-time because they are instead forced to work multiple part-time jobs:
You know, the media tries to tell us that the Obama-Clinton economy is the new normal. That stagnation is what we should come to expect. That there’s nothing better. We have the lowest percentage of Americans working today since 1977. Wages have been frozen for 20 years. Median wages today are the same as they are, as they were in 1996. Now that has been driven by illegal immigration that Washington refuses to solve, and that has been driven by economic policies that hammer the living daylights out of small businesses …. Single moms, struggling to feed their kids, working two, three, four part-time jobs because Obamacare doesn’t let them work full-time. Seeing their wages held stagnant, driven down—all of that can turn around. And if we do the two major legislative initiatives I’m campaigning on—if we repeal Obamacare and pass a flat tax—we will see millions and millions of high-paying jobs for people struggling to achieve the American dream.
But this assessment was utterly wrong. Not only did Cruz get the basic facts about the ACA’s effects on jobs incorrect, he also failed to take into account the policies that could actually help improve the lives of single mothers—many of which he has actively opposed.
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A January study in policy journal Health Affairsfound “little evidence” to support some lawmakers‘fears that the ACA’s employer mandate, which requires those with more than 50 full-time employees to offer health insurance, would shift many full-time workers to part-time as employers attempted to side-step the law. Although the study found small changes to part-time work among some groups, CNBC reported, this “could not be attributed to the Obamacare employer mandate.”
A September 2015 survey from the Kaiser Family Foundation and the Health Research & Educational Trust similarlyfound that between January and June 2015, the vast majority of employers did not push employees to part-time work or reduce the number of people they hired because of the ACA:
The percentage of firms that offer health benefits to at least some of their employees (57 percent) and the percentage of workers covered at those firms (63 percent) are statistically unchanged from 2014. Relatively small percentages of employers with 50 or more full-time equivalent employees reported switching full-time employees to part time status (4 percent), changing part-time workers to full-time workers (10 percent), reducing the number of full-time employees they intended to hire (5 percent) or increasing waiting periods (2 percent) in response to the law.
This is not the first time Ted Cruz has falsely claimed the ACA pushed people to part-time work. During a January GOP debate, Cruz said that the health-care law “is the biggest job-killer in this country, millions of Americans have lost their jobs, have been forced into part-time work.”
Fact-checkers and media outlets quickly called out the statement as a falsehood. Politifact gave Cruz’s assertion a “pants on fire” designation, writing, “By every measure, millions more people are working and millions fewer are stuck unwillingly in part-time work since the time the Affordable Care Act became law. The law might have affected part-time work for certain kinds of people, but that didn’t change the improvement in the overall numbers.”
There is one thing Cruz was right about, however: Wage stagnation is a huge problem for Americans. But according to economic experts, it isn’t health-care reform or “illegal immigration,” as Cruz suggested, that is primarily at fault.
Instead, the real culprits responsible for wage stagnation, which continues to fuel economic inequality in the United States, are policymakers who have prioritized raising the incomes of the top 1 percent of earners. Lawrence Mishel, Elise Gould, and Josh Bivens explained in a January 2015 report for the Economic Policy Institute that “wages were suppressed by policy choices made on behalf of those with the most income, wealth, and power.”
Among those policy changes listed by Mishel, Gould, and Bivens has been the failure to raise the minimum wage, which they write “had especially adverse effects on women” and people of color.
“Less than half of all workers are women, but they account for 75 percent of workers in the 10 lowest-paid occupations and about 60 percent of minimum wage workers,” explained Laura D’Andrea Tyson, the former head of the Council of Economic Advisers and the National Economic Council, in a 2014 article for the New York Times.
“And most women earning the minimum wage are not teenagers, or wives who can rely on a spouse’s income. About three-quarters of female minimum wage workers are above the age of 20, and about three-quarters of these women are on their own. Many, of course, are working and taking care of children,” Tyson continued.
In other words, many of the single mothers Cruz expresses such concern for would disproportionately benefit from increasing the minimum wage.
Yet Cruz has steadfastly opposed doing so. Speaking at a private donor event in January 2015, the Texas senator claimed that the existence of a minimum wage at all “hurts the most vulnerable.”
Cruz also voted against raising the minimum wage during his time in Congress. In 2014, he voted against the Minimum Wage Fairness Act, and in 2015 he voted against a budget amendment introduced by Sen. Bernie Sanders (I-VT), which would have established “a deficit-neutral reserve fund relating to promoting a substantial increase in the minimum wage.”
The worry Cruz showed for single mothers and their children also seems to fall short when it comes to other policies advocates say could make a difference in the lives of that group. Take paid leave, for example, which would provide paid time off to care for a new child or sick family member. Single parents face a greater risk that “caregiving will conflict with work,” according to the Center for American Progress.
A 2015 study of low-income mothers in New York City conducted by the Community Service Society found that, lacking paid family leave, many women with a new child experienced “financial hardships and anxiety about holding on to their jobs, forcing them to return to work quickly, some when their infants were just two or three weeks old.” Many were also forced to leave the workforce altogether because of lack of accommodations and job security.
“Because most of these women quickly exhausted their accumulated sick leave or few vacation days, and because they received no other form of compensation, they soon fell behind in their ability to pay their bills—even if they returned to work only a few weeks after having given birth,” the study found. “When employed, these women had lived very close to the edge, so the absence of a regular paycheck, even for only a short time, was enough to put them over the brink.”
Yet Ted Cruz does not support federal mandates for paid family leave that could help relieve some of the financial pressures parents face that force some out of the workforce altogether. Last September, Cruz told a representative of Make It Work Iowa that while he thinks “maternity leave and paternity leave are wonderful things” that he supports “personally,” he nevertheless doesn’t “think the federal government should be in the business of mandating them.”
Although Cruz may feign concern for “single moms, struggling to feed their kids,” his policy positions show a clear lack of desire to enact changes that would actually help those families.