Hawaii ranks last in funds for pregnancy prevention
Health officials say budget losses force them to be "creative"
Hawaii ranks last among the 50 states in public funding for services to help prevent unplanned pregnancies, the Guttmacher Institute has reported.
The first ranking of states also shows Hawaii is 47th in providing contraceptive services and supplies, fifth in laws and policies likely to facilitate access to such services, and 37th overall.
California leads the nation with the most effective laws and policies, and Nebraska had the lowest national ranking, according to the study.
Hawaii is last in the funding category because of financial restrictions within the state government the past 10 years, said Loretta Fuddy, chief of the Family Health Services Division, state Health Department.
All general fund money for family planning services was eliminated from the state budget the past decade, she said.
According to the study, public funding dropped 55.4 percent in Hawaii per woman in need of contraceptive services and supplies -- to $21.59 in fiscal 2001 from $48.37 per woman in fiscal 1994.
"How we have provided family planning services in some ways has been creative," Fuddy said, describing how federal dollars have been used for education and to provide contraceptives to community health centers.
The centers also receive subsidies for medically uninsured clients so they can access family planning, she said.
"Simply because we have reduced the general fund dollars to family planning, I think we have done very well," Fuddy said.
Nancy Partika, executive director of the Healthy Mothers, Healthy Babies Coalition of Hawaii, also said the Health Department and community centers "are doing a very good job" of providing family planning services despite inadequate state and federal resources.
"But there needs to be more recognition of the issue, and there absolutely needs to be more sources addressing unintended pregnancies," Partika said, pointing out, "An unintended pregnancy leads to poor health outcomes."
Fuddy noted several positive trends:
» Hawaii's unintended pregnancy rate as of 2003 was 46.9 percent; in 2001 it was 55.7 percent.
» The birth rate in Hawaii in 2003 was 14.4 per 1,000 population, compared with 21.2 per 1,000 population in 1970, a 30 percent reduction.
» The overall pregnancy rate for teens was 27 percent in 1994; in 2003 it was 20 percent. For teens 17 and younger, the pregnancy rate was 12.2 percent in 2004, Fuddy said.
"Again, I think we're showing some positive movement, and I think that's the result of some legislation," she said, noting Hawaii's high ranking in laws and policies in the Guttmacher study.
"We are concerned that we don't have the funding we once had from the general fund perspective, but we have done well to leverage federal dollars and state subsidies that go to community health centers," Fuddy said.
She said the Health Department is working closely with the schools with abstinence funding and temporary assistance to needy families through the Department of Human Services. The agency also is working with community health centers "toward more healthy choice education, and not just clearly focusing on contraceptives."
The Guttmacher Institute, a New York-based nonprofit organization that studies reproductive health issues, said the United States has one of the highest unintended pregnancy rates of industrialized countries.
It said half of 6 million pregnancies occurring annually in America are unplanned, and 1.3 million end in abortion.
STAR-BULLETIN / 2001
The Guttmacher Institute reported these findings about Hawaii, based on data between 1994 and 2001 from the U.S. Bureau of Census or National Center for Health Statistics:
» Of 254,080 women of child-bearing age, 27,250 become pregnant each year, with 64 percent of pregnancies resulting in live births, 21 percent in abortions and the rest ending in miscarriage.
» Hawaii has the 12th-highest teenage pregnancy rate in the nation, with 3,600 teen pregnancies annually. Of those, half result in live births and 37 percent in abortions.
» Hawaii's teenage pregnancy rate dropped 34 percent between 1992 and 2000.
» Contraceptive services and supplies are needed by 138,110 women, including 62,020 who need publicly supported services because their income is below 250 percent of the federal poverty level (46,180) or they are sexually active teenagers (15,840.)
» Ten percent of women from 15 to 44 years old have incomes below the poverty level, and 2 percent of women in that group have no medical insurance. About 10 percent are enrolled in Medicaid.
» Hawaii has 33 publicly funded family planning clinics that provide contraceptive services to 9,020 women, including 4,280 sexually active teens.
» State and federal funding for contraceptive services and supplies in Hawaii totaled $1,339,000 in 2001, with $22 spent per woman in need of services.
» The family planning clinics help women prevent 5,100 unintended pregnancies annually. The federal and state governments saved $3 for every Medicaid dollar spent for every prenatal and newborn care.