Saying No to Abstinence-Only Funds: An Analysis of State Decisions

Much of the current proliferation and political success of abstinence programs can be credited to a measure included in the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), commonly known as “welfare reform.” Abstinence-only education was nested within this high profile welfare reform bill, suggesting that was part of a larger plan to combat poverty. Under this program $50 million was allotted to the states per year. The amount of money available to each state is based on the state's proportion of low income children relative to the national total. These abstinence funds are awarded largely as block grants to the states, and the states must match every $4 of federal money with $3 of state funds.

When the program began, only 1 state (California) refused to participate but over time, many more states have declined this lucrative source of funding. This study explores why states have taken the unusual step of turning down federal funds. In doing so, we examine a number of political, economic, and social factors that may influence a state's refusal to participate. Using case studies and multivariate analysis, we investigate these relationships and discuss their implications for public health policy.