Category: Population

Related directly to population issues.

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Family Planning Population

Watch East Los High

There was an omission in my last article about the effectiveness of the media on teen pregnancy rates. Bill Ryerson, one of the world’s most effective population activists, kindly reminded me of my mistake in leaving out an important example of the use of modern media.
“East Los High” is an online TV series aimed at Hispanic teens. All the episodes of the 2013 season and several episodes for 2014 are available at www.hulu.com. Be prepared for an advertising blitz, and for an introduction to a very different lifestyle.
When I was in high school I knew that guns, shootings, teen pregnancies and drugs all existed, but I had no personal experience. Times have changed. I watched several episodes of “ELH” with real apprehension because of the problems these adolescents endure—and the excellent quality of the acting.
In between the violence and sex are some sweet but instructive scenes. Jacob is a football hero who discusses with his dad whether he should join the military or not. His father recommends that he take advantage of a sports scholarship and be the first in his family to go to college.
Jessie is a very good student who doesn’t date and belongs to the “Virgin Club”. She is a junior and so is amazed when Jacob, a senior, asks if she will help him study chemistry. The study session turns out to be more when he becomes amorous. She protests, pushes him away and says that she is still a virgin and needs more time.
“I totally understand if you think I’m lame and you don’t want to hang out no more,” she says.
“Hey, I don’t think your lame” Jacob replies.
In another episode a dancer announces to the dance team’s head that she is pregnant. “I thought that you were on the pill” was the angry reply.
“I am. Unless I forgot to take it.”
“Stupid, the pill won’t work if you don’t take it every day. Why didn’t you take the Plan B pills I gave you?”
“Do you have any on you?”
“It’s too late, pendeja. You have to take the pill within 3 days of having sex.”
Then comes reality testing about the future of the dancer—and of the pregnancy. Her boyfriend seems happy to become a dad, and invites the young woman to stay at his house after her aunt kicked her out. When he introduces the mother-to-be to his mother, the older woman tells him to throw her out.
“I can’t. She’s going to move in. She’s having my baby.”
“Again?” was the baby’s grandmother’s reply. Apparently this older man had caused more than the one unplanned pregnancy.
Has this program lowered teen pregnancy rates, reduced drug use or caused any other improvements? it is too soon to tell. However, ELH is under the watchful eyes of two communication professors, Drs. Arvind Singhal (University of Texas, El Paso) and Helen Wang (University of Buffalo). They have been using several techniques to measure the program’s impact. The results are very encouraging.
As expected, ELH is most popular in areas with the most Hispanics. Many people watched the show more than once because of the high appeal of the stories. This appeal has spread to Facebook, whose interactive properties engaged the audience even more. Furthermore, over 25,000 people have linked from one the show’s sites to reproductive health service providers in Los Angeles alone.
Closer to home, the teen pregnancy rate in Colorado has taken a nosedive. It has shot down 40% from what it was just 5 years ago. This decrease is important because, on the average, children born to teen moms don’t succeed as well in life. Furthermore, a teen mother’s chances of completing education are lessened and adolescent pregnancies are expensive to society. From a financial standpoint, every dollar spent on family planning saves $3.74 in Medicaid costs for maternal and newborn care. The human savings are much greater, of course.
Title X (ten) is a government program that works. It provides reproductive health services to women of any age who otherwise would have difficulty affording them. Here in La Plata and Archuleta Counties clinics offer women disease screening and their choice of family planning.
One of the reasons for the recent success of Title X clinics is that they are able to provide Long Acting Reversible Contraception (LARC), such as IUDs and Nexplanon®. Do you remember when you were a teen, how forgetful you were? LARCs remove the risk of forgetting to take “the pill”—the problem of the dancer in East Los High.

© Richard Grossman MD, 2014

Categories
Population

Turn ON Your TV

It is over 14 years since we’ve had TV in our home except for an old set to watch movies. Yet I recognize that TV can do wonders in changing people’s attitudes and behavior.
Perhaps you remember reading about the effect of TV in Brazil. The family size is less than half of what it was 50 years ago. Although there are many factors that have brought about this rapid decrease, one of them was unintentional. TV telenovelas (what used to be called “soap operas” when I was a kid) are very popular in Brazil. They depict families dealing with the usual joys and problems that people handle all over the world. Can you imagine being the director and trying to supervise four kids on a TV set? As a consequence upper middle class TV families have only one or two kids, and this has become the Brazilian ideal.
Consciously or unconsciously, people follow the models that they see in the media. That is why advertising is so powerful. And that power can be put to good use.
Miguel Sabido pioneered using radio and TV to educate and change behavior. “What we know today as the Sabido methodology, or ‘Entertainment-Education,’ was not born miraculously one day”, he wrote. “It started as a childhood dream, conceived almost 50 years ago, when I understood that the housekeepers at my house in Mexico literally believed everything they saw in Mexican telenovelas (‘soap operas’).”
The first time Sabido actually tested using the media to educate and entertain was in 1977. He launched a primetime telenovela to educate viewers on family planning in Mexico. Acompañame (Accompany Me) focused on the issue of family harmony and educated viewers about family planning. During the time it was aired there was a 33% increase in attendance at family planning clinics as well as a significant increase in the sale of contraceptives. Acompañame was followed by other telenovelas with similar messages, all helping to lower the Mexican population growth rate.
Today the foremost organization to use the Sabido method of entertainment/education is the Population Media Center (PMC). The Center works in 18 countries, including the USA. They have branched out from just informing their audiences about family planning; now they promote empowerment of women, avoidance of HIV, and encourage education and reproductive health in general. They use “…serialized dramas on radio and television, in which characters evolve into role models for the audience for positive behavior change.”
An example is the Center’s program to combat abuse. One third of girls and women will suffer physical, mental or sexual abuse during their lifetimes. Usually the perpetrators are males who learn the pattern of abuse when they are young. This abuse can devastate women and be harmful to the men, too. Fortunately, PMC has a program geared to combat abuse worldwide. Designed for computer-savvy young teens, Breakaway is available in four languages.
“Sixteen and Pregnant” is a very popular series on MTV, showing pregnant teens who struggle with life after becoming pregnant. In the episode that is available free online, Aleah, 18, contends not only with the pregnancy but also diabetes and an irresponsible boyfriend. Now 5 years old, this program is a very popular reality show that has made its mark with adolescents. There are also follow-up shows, “Teen Mom”, that track some of the young mothers’ lives.
“Sixteen” and its spinoffs have had a major influence on teens in the USA. The teen birth rate has (fortunately!) hit all time lows—and part of that success is due to “16”. A careful analysis suggests that one third of the decrease can be attributed to “16”! The poor economy is another reason that adults and teens both are having fewer babies, and the availability of family planning for teens ahs decreased the number of unplanned pregnancies. Fewer births, fortunately, is not the result of increased abortions, all too common in TV commercials.
There were two ironies in the episode of “16” I watched. Most egregious was an advertisement—of which there were many. One ad, for a cherry-flavored cola, used sex to sell its product.
The sad fact is that Aleah lives in St. Louis, which has a wonderful, innovative family planning program. The Choice Project provides women of all ages with free contraception.
We can celebrate that the teen birth rate has plunged. The study of “16” ends with these words: “We find that media has the potential to be a powerful driver of social outcomes.”

© Richard Grossman MD, 2014