Posted tagged ‘abstinence’

Sarah Palin Substance, Take Two

September 3, 2008

Most of the press and blog coverage today has focused on (a) the water torture nature of the story of what happens when you don’t vet the first significant “Presidential” appointment  you make — thus aiming the coverage appropriately at the real culprit in Palin story:  John McCain. If this election is in fact a “judgment” vs. “experience” choice, then for now, judgment is winning, as indeed it should.

At the same some folks are pointing out that the kinds of trouble Palin herself is in — and hence the sort of problem she is becoming for John McCain — may be the kind of briar patch in which the GOP ticket is perfectly happy to find themselves, the argument being that in a change year, a gut-level populist appeal may be just enough to turn the key states their way.

So, against that possibility, I want to take another whack at what a Vice President — or a President — Palin looks like from a point of view embedded in science.  As before, my argument is in essence that what Palin thinks about a specific issue for which there is a clear body of research — using scientific methods, producing reproducibly results — tells us not only about the rationality of her position on that particular issue, but also about the quality of her mind, her judgment, her ability to make decisions of the sort a President faces.

The obvious place to start here is, I’m afraid, with sex — in particular, with Palin’s judgment about the most effective way to education adolescents about sex.  As we now know, both through the usual political research process and because of news about her family I will not discuss, Sarah Palin believes that the correct way to instruct children about sex is to avoid what she calls “explicit sex education” and teach only that abstinence is the appropriate behavior before marriage.

OK — that’s a view a fair number of people hold.  But Palin, of course, is not just anybody — she’s been mayor and she is governor, and you would think that she has some responsibility to back ideas not only because they are comfortable, but because they are valid.

Not so here.  There is ample evidence that abstinence education does not work. See here for one recent take on this, and see this for my earlier whack at Mike Huckabee on this same issue.  Cruise the blogosphere to find as much more as you would like.  Bottom line:  abstinence education shows no improvement in the key parameters of sexual behavior or outcomes over control groups in repeated studies, one of the best of which can be found in summary here.

But  you knew that already, didn’t you?

Now it is something of a dog bites man story to suggest that an evangelical Christian would favor abstinence teaching for her own family, or even her own community; but the point here isn’t about personal choice or belief, it’s about the ability to perform evidence-based reasoning.

Put this another way:  there is a street definition of neurosis as repeatedly doing the same thing expecting a different outcome.  A scientifically informed policy would look at the grim statistics:  the US is the world leader among developed countries in teen pregnancies (h/t Dem from CT over at Daily Kos).  The good news had been that despite that dismal result, teen birth rates had been falling since the peak rate of 61.8 birth rates per thousand in 1991. That is to say, the decline began at exactly the time a Democratic adminstration took office — one whose record on evidence based policy is, by and large, exemplary.

So what happened over the last seven years, during which an administration whose full throated support of world wide abstinence education has had its chance to work its wonders on American women and girls?  What’d you’d naively expect:  the latest report from the Centers For Disease Control, analyzing the data from 2006, shows the US teen birth rate after a fourteen year decline, started to climb again in 2005, a rise that continued in 2006.  From 40.5 births per thousand, the 2006 data show an increase to 41.9.

So it goes, as the late KV would have said.  Idiocy, a lesser evil than the deaths to which Vonnegut referred, is also always with us.

But to the deeper argument:  we know some things.  We know that abstinence education does not work, that funding it is a kind of welfare scam to benefit the religious right, that the real world consequences of the totality of US policy in this area has produced a dismal record of preventing teen pregnancy (80 percent of them unwanted, according to CDC figures, btw).  We know that teen pregnancies have all kinds of deleterious social effects, as the CDC noted in this passage in one of their reports:

“The National Campaign to Prevent Teen Pregnancy recently estimated that $9.1bn in public funding was expended on teenage childbearing in 2004. These costs include public assistance, healthcare, child welfare and other expenses.”

And let me repeat — we know that abstinence education does not work.

So what would a rational leader do here, one who understood the processes of scientific investigation and could interpret its results?

Try something else perhaps?

Or not.  Both Sarah Palin and John McCain have voiced their continued support for abstinence education as we know.  There are only two explanations that adequately account for such a choice.  One is that they know better — they know that this policy does not help and correlates with a development in the wrong direction, but they feel that they need to take this position to satisfy their base.  Or they simply do not allow facts to penetrate ideology.  (If anyone has any other possible explanations, I’d love to hear them.)

The first option suggests that McCain and or Palin are cynical and so hungry for power that the unwanted pregnancies of deliberately poorly informed teenagers are an acceptable price to pay for success in November.  The second suggests that either or both lack the capacity for judgment, the ability to analyze data, assimilate and interpret information, and come to conclusions for the greater good of the people they seek to represent.

That is — when you choose to reject the bits of science you dislike, you lose the abiltiy to distinguish between scientifically defensible conclusions and stuff you just would rather believe.  While such an approach to the world is comfortable — inconvenient facts cannot overturn settled assumptions, the real world has a way of biting such poor judgment in tender places.

I honestly don’t have a clue whether in either case cynicism or willed ignorance is the explanation for the two GOP candidates on the national ticket deciding to go all in for abstinence.  On their history — McCain has much less of a public commitment to the culture wars side of his party, so maybe pure hunger for power has an edge there.  Palin’s commitment to extreme religious views is also well documented, so perhaps hers is a sincerely chosen blindness.

But I will say that in either case, taken as a case study of a larger test of the way our candidates think and would govern, either explanation leads to the conclusion that this ticket does not think about the world in the ways Presidents need to do.

As for the question of simple humanity, it is worth noting that Governor Palin used her line item veto this spring to cut funding from the Alaska state budget that reduced support for Passage House, a transitional home for teenage mothers.  I have some direct knowledge of institutions in other states that perform a similar service, and let me tell you, the damage a loss of this kind of support can do to both young mothers and their children is immense.  While I fully agree that families are off limits, it does seem to me to be within bounds to say that it seems to me both socially sound policy and a moral good to extend as much of the support a loving family can give to an unplanned pregancy to all those who need it.

Image:  Ary Scheffer, “Greek Women Imploring the Virgin of Assistance,” 1826. National Museum of  Western Art, Tokyo.  Source: Wikimedia Commons.

Bad Science Kills, take two: Bush admin. fears sex, other people die edition.

February 19, 2008

From 365Gay.com via No Capital by way of Eschaton comes this reminder why it really hurts when we are led by those who fear not just sex, but facts.

The Bush administration and Congress are arguing about the renewal of the African Aids initiative. At issue: whether or not to preserve the rigid requirement that one third of the funding must go to abstinence programs.

Bush argues (Sunday, February 16, in Tanzania) that there should be no problem with his approach. Why, says he? Because

My attitude toward Congress is, see what works…PEPFAR is working. It is a balanced program. It is an ABC program – abstinence, be faithful and condoms. It is a program that’s been proven effective.

Except, of course, that it is not, for two reasons — both captured in (let’s be kind) two mistatements in the brief quote above.

Does abstinence education work? Not in this country. See this post for my earlier take on that issue. In Africa? Not so much there either. From Britain’s The Independent comes a report from Uganda, once the poster child for successful government-led HIV/AIDS prevention policy.

Aids activists and development officials point to the 130,000 Ugandans infected with HIV last year alone – up from 70,000 in 2002 – and say the recent obsession with abstinence is handicapping the country’s once-successful fight against the virus.

How successful was that earlier approach? Try this:

Under the previous “balanced” strategy, condom distribution grew from four million a year to 118 million by 2001. Thanks to the abstinence message, teenagers lost their virginity about 18 months later than before. People with several partners realised they needed to stop sleeping around so much. In 1992, one in five Ugandans had Aids. By 2001 that dropped to one in 20.

Not bad. Damn good, in fact. To take the Talmud’s view that to save one life is to save a world, here’ s a public health intervention that has preserved a human multiverse.

But what of the claim that Bush’s policy is balanced? Not so much there, either. On the ground where services are actually delivered, the mandated requirement to promote abstinence has squeezed the condom message out of what was supposed to be a program that worked by enabling individuals to exercise choice and responsibility for their own actions. Instead…

What has changed in Uganda is that condoms are no longer promoted to the general population. In line with US Aids policy under Mr Bush, condoms should be promoted exclusively to high-risk groups such as truck drivers, soldiers and “discordant” couples (where just one of the partners is HIV-positive). Everyone else should hear the rubber-free virtues of abstinence and fidelity only. Yoweri Museveni’s government hungrily devoured the American abstinence policy and the attached cash. It is dependent on foreign donors for half its budget.

“We have worked so hard to get people to understand HIV and that there are three options open to them: A, B or C,” says Dr Henry Katamba. “That’s Abstain from sex, Be faithful or use a Condom, whichever is the one for you. That’s what our government used to say – and everyone understood. The message recognised that it wasn’t realistic to ask for abstinence from everyone who’s not married.” Dr Katamba is health co-ordinator of the Uganda Protestant Medical Bureau, an umbrella of churches providing clinical help in the absence of government hospitals.

“Because of the US, our government now says Abstain and Be faithful only,” says Dr Katamba. “So people stop trusting our advice. They think we were lying about how condoms can stop Aids. Confusion is deadly.”

“Deadly.” Let that word sink in.

I’ve written elsewhere on this blog about the way that some of our leaders, at least, choose death before dishonor, as long as it is someone else — someone negligible, like an anonymous heroin addict, or some distant African at risk for HIV/AIDS — who actually does the dying.

The usual analysis of this disgraceful division of labor turns on the political calculus of interest groups and the Rovian tactic of keeping the literalist evangelical “base” calm and happy. But whatever the truth of that argument (and who knows whether Bush argues for abstinence out of calculation or genuine belief), such mind reading misses the larger point.

Scientific illiteracy is not ignorance of any given fact. George Bush does not need to know the curve that fits the data on the rates of infection in different sub-Saharan countries. He does need to pay attention, though, to the fact that such knowledge exists, and says something important about the world and the consequences of US action.

Instead, in the government we have now, facts and the process of inference from facts are subordinate to pre-existing certainties.

Among them: Sex is bad in and of itself, except in certain, tightly defined circumstances. If you choose to go ahead and do the nasty in defiance of that moral “truth,” then be prepared to take the consequences. (Even if you didn’t choose – of course, but I’m not even going to go down that sewer just now). You made your bed, man or woman (or unborn child) … now die in it.

This is how science matters in public life. It’s not, to my mind, the question of funding choices – should physics get more than chemistry; neuro more than endocrine biology or what have you. It’s not about Obama liking NASA and the manned space mission less than Clinton. It’s whether or not our leaders understand the idea that facts have consequences.

When someone makes a claim about material events in the world, scientific thinking provides the only reliable method to test that claim. You have to get the data, analyze it, and expose the tools of your analysis to scrutiny as well. If you don’t you get what we have: policies that defend ideological purity, literally to the death.

I’ve written this before; I’m sure it’ll come up again. That’s what makes the practical consequences of bad science not just tragic, but criminal.

Images: Nicholas Poussin, “The Plague of Ashdod.” 1630-31. Source: Wikimedia Commons
Special costume to be worn by medical men confronting the plague. Germany 17th century.  Licensed under a GNU free documentation license Ver. 1.2 or any later version published bythe Free Software Foundation.  Source:  Wikimedia Commons.