Current Intervention
Although the teenage pregnancy rate in New York City has
declined by 27 percent over the last decade and roughly matches the national
decline rate, there are still more than 20,000 teenage pregnancies in the city
annually and nearly nine out of ten of them are unplanned (1)(2). The problems
associated with teen pregnancies are well-known, far-reaching and must be
confronted as a society. Unfortunately, efforts last year to address this
problem in New York City have been controversial and giving rise to other
problems. The primary reasons for the ineffectiveness of the well-intentioned
intervention by NYC’s Human Resources Association (HRA) can be attributed to
their failure to do comprehensive research on the social and economic
determinants of teenage pregnancy and their failure to utilize popular social
and behavioral theories to connect with targeted population and encourage
positive behavioral changes.
New York City’s HRA is the municipal agency that provides
social services to over three million New Yorkers (3). This reputable
organization has sparked fierce debate among reproductive rights activists, anti-oppression
groups, anti-abortion groups, pro-choice groups, and anti-discrimination organizations
in the city and nationwide after launching their new teenage pregnancy
prevention campaign. The City of New York spent $400,000 and two years
developing the campaign, which includes three components: public transportation
advertisements, information-based text message program, and videos (4). This
paper will focus on the advertisements that can be found at bus shelters and in
subway cars because of the three elements of the intervention, this one is the
farthest reaching. Like ads used by big corporations that impose themselves
upon an individual, the five ads in this campaign are strategically placed in
public transportation locations because a lot of people, particularly teenagers,
frequent these locations. The primary purpose of the advertisements is to provocatively
remind young people that there are great implications associated with raising a
child as a teenager. The ads raise issues of poverty and the personal and financial
price teenagers must pay, which are inherent components of child-rearing that parents
must sacrifice.
The
ad campaign is quite simple: use blunt and confrontational ads to convey to the
youth of the city the realities and challenges of parenthood and to encourage responsible
preventative behaviors. Representatives for the mayor, who is infamous for
implementing other controversial public health campaigns, stated that NYC can
no longer be “value neutral” about teenage pregnancy and that the city must
“send a strong message that teen pregnancy has consequences — and those
consequences are extremely negative, life-altering and most often disproportionately
borne by young women” (5)(1). The forthcoming sections will discuss the
shortcomings of the HRA’s teen pregnancy prevention campaign through a careful analysis
of the behavioral model it uses, the reactions it provokes, and the deeper unintentional
impact of the city’s intervention. Recommendations for an alternate
intervention will be presented following discussion on critiques of the HRA
campaign and how the city can utilize it to improve its public health
initiative.
Critique Argument 1: The HRA institutionalizes racism in New
York by perpetuating negative labels of Black and Latino populations
Only one of the five babies used in the HRA ad campaign
is white, while the rest are of Black, Latino or mixed ethnicity (6).
Evidently, the primary target for the HRA ads are young people of color,
particularly teenage women, as it should be considering that teenage pregnancy
in New York City disproportionately occurs in the Black and Latino teenage
population. In 2011, New York City’s pregnancy rates for Black and Latina women
under the age of twenty were 26% and 39%, respectively, which accounted for
nearly two-thirds of the teenage pregnancies that year (7).
While the HRA is correct to target the Black and Latino
youths of New York City for an intervention to reduce the teen pregnancy rate, they
employed a negative use of labeling theory in their ads, which has profound and
dangerous implications for the mental health of minority youths and for the
racial dynamic of New York society. Given that humans have a natural biological
capacity for predictably irrational behavior, labeling theory asserts that
casting a label on an individual or a group of people will have an effect on
how that person or population is treated. In one study example, labeling theory
is supported with how the irrationality of teachers affects student
performance. The study found that when elementary school teachers judged
potential performance of children by being shown pictures of incoming students,
the white children were consistently expected to do better than the black students
based solely on their pictures (8).
Essentially,
labeling theory illuminates the unwarranted but commonly made assumptions that
are made about an individual or group of individuals in normal everyday
interactions. With a clear understanding of labeling theory, it is evident that
the use of predominantly babies of color in the HRA’s ads, commissioned by the
City of New York, perpetuates the stereotype that most people of color will
become teenage parents. The public display of this stereotype presented as a
fact will consciously and subconsciously affect how the general population
treat and view young minorities, particularly the young female teenagers.
In
addition to the consequences in the larger society, the impact of negative
labeling has profound effects on an individual’s internal psyche. The
internalization effect can be understood through the results of a study that
tested the effects of being stereotyped an Asian or a woman, where a sample of
Asian women were given a math test with a prompt on race beforehand. The
researchers discovered that when participants were given a prompt that reminded
them that they were Asian, they achieved higher than average scores on the
exam; however, when participants were given a prompt that reminded them that they
were a woman, their scores were significantly lower. By being confronted with
those stereotypes right before the exam, the participants internalized them and
their behavior was subsequently affected (8).
Thus,
the principles of labeling theory illuminate the deep racial implications for
the people of New York City. Firstly, people who see the campaign will
internalize that minority teenagers are mostly destined to be poor teenage
parents, and will thus consciously and subconsciously treat them accordingly,
which could potentially expose young minorities to more situations of
institutionalized and personally-mediated racism. Secondly, the young teenagers
of color will experience internalized racism from the stereotypes perpetuated
in the ads, causing deflation in their self-esteem and accepting these negative
perceptions of themselves. Internalized racism will trigger behaviors and
practices of minority youth that contradict the literal message of the ads
because they will believe and accept their pre-determined fate from the HRA’s
deplorable and paradoxical application of labeling.
Critique Argument 2: The ads stigmatize teenage parents by
ignoring the socioeconomic factors that contribute to teenage pregnancy
The HRA deftly uses framing theory to deliver a provocative
and memorable message in their ad campaign by relying on the visual image of a
baby to convey the core value of wealth and deliver strong catchphrases
(e.g.“Got a good job? I cost thousands of dollars each year”) to drill their
core position of having a baby as a teenage will be expensive and will likely
result in a life of poverty. Provocative additional catchphrases such as,
“Think being a parent won’t cost you? NY State law requires a parent to pay
child support until a child is 21,” reinforce the HRA’s core position that
teenage pregnancy leads to poverty. While the intense public debate that has
ensued as a result of the campaign substantiates the degree of the frame’s
power in appealing to the values of wealth and stability that people hold
strongly, it also invokes anger and stigma, which the HRA did not anticipate.
Although the public is well aware of the difficult challenges that teenage
parents face, the ads’ effects of shaming and framing poverty as a result of
teenage pregnancy only intensifies the level of stigma and shame that teenage
parents already endure. The ads dehumanize teenage parents by referencing them
as sad statistics and labeling them as forever doomed to a life of poverty for
themselves and their children
. The HRA’s core position correctly recognizes the existence
of a strong relationship between poverty and childbearing rates of teenagers.
However, the causal association incorrectly identifies poverty as the outcome;
when in fact, many studies, including a recent study by Kearney and Levine in
2012, found that teenage pregnancy is actually the outcome. The researchers
concluded that the poorest people believe they have slim chances of economic
mobility and therefore have children at a young age instead of attempting to
improve their economic progress because they perceive limited possibilities in
socioeconomic advancement. Moreover, the scientists emphasized that poor girls
who bear children as teens do not suffer worse economic outcomes than similarly
poor girls who have children later, which refutes the mainstream association of
poverty and teenage pregnancy that the HRA propagates (9).
The use of framing theory in NYC’s print ad campaign has deep
implications for teenage parents and young people with poor socioeconomic
status. By only providing catchphrases and statistics on the ads which use a
misleading frame, the HRA fails to inform the public on correct facts and
provide more substantive information, like support programs that address the
disparity of social and economic factors by assisting impoverished people in
trying to lift themselves and their families out of poverty.
Critique Argument 3: The confrontational approach of the ad
campaign will likely result in resistance and potentially more harmful effects
Multiple research studies conclude that confrontational
and provocative approaches such as the one taken by the HRA are ineffective in
preventing or changing the risky behavior. The HRA incorrectly assumes that the
confrontational tone of the ads will scare young people to practice behaviors
that will prevent unplanned pregnancies. However, according to the
psychological reactance theory, it is more likely that the harsh nature of the
messages will trigger resistance among teens because they will feel that some
of their perceived freedoms are being threatened. More specifically, the youth
will have a rebellious reaction and adopt the opposite behavior of preventing
teen childbearing to resist the threatening message pushed by the HRA campaign,
which threaten their perceived freedoms of choice and independence in relation
to their relationships, careers, sexual activity and family planning.
Driscoll’s
study on parental opinions of a partner and its impact on that relationship found
that when couples face external or parental opposition, they experience the
Romeo and Juliet effect, that is, intensified feelings of love (10). This study
validates the psychological reactance theory that people tend to cling more
tightly to a behavior or belief they associate with a particular freedom
whenever they feel that freedom is being threatened. In addition, a study on
the use of confrontation as a form of substance abuse counseling found that
utilizing a confrontational approach to counter a risky behavior actually
evokes resistance in the individual or group being counseled, which
subsequently prevents a positive behavioral change (11).
Thus,
the confrontational captions like, “Honestly Mom…chances are he won’t stay with
you. What happens to me? Are you ready to raise a child by yourself?” on the
various issues of high costs, risk of poverty, child support, unfinished
education will likely be perceived by teenagers as a challenge, thereby
negating the purpose of the entire intervention.
Proposed Intervention
The proposed
intervention will also be an advertisement campaign that will be found in
subway cars and bus shelters in all five boroughs of New York City. While this
ad campaign will target the same at-risk population, it will achieve the goal
of reduced pregnancies in a much different manner. Instead of a confrontational
approach that centers on shaming individuals and a segment of the population,
it will utilize a positive, informative and relatable approach that seeks to
empower minority youths, suggest alternative aspirations, offer the freedom to
make their own choices, and provide information on how to access the tools and
resources to improve economic mobility and work towards escaping poverty. This
proposed campaign will display real teenagers of color from impoverished
neighborhoods who share their uplifting stories of how they achieved
considerable goals like going to college or getting a dream job. In addition,
they will share information on how to access the resources and HRA social
programs they used to achieve their goals. Moreover, some of the ads in the
campaign will show the teens debunking common myths about contraception and
birth control methods, and offer information on how to access them in New York
City. This proposed intervention will learn from
the critical mistakes made in the HRA’s ad campaign and will work to address
each of the aforementioned flaws.
Defense 1:
Overcoming Stereotypes and Empowering Young Minorities
Firstly, this proposed intervention will combat the racism
perpetuated by the HRA’s use of labels that stereotype minority teenagers with
the use of advertising theory. A major component of advertising is grounded in psychological
reactance theory to understand how messages, their delivery, and their content
can influence behavior. Success in the delivery of messages depends on the likability
of the messenger. That is to say, if the messenger is not someone that the
receiver finds likable or relatable then there is a risk that teenagers might
not take to it (12). Considering the importance of the messenger, this
intervention will deliver its message through real New York City young adults
who represent various racial backgrounds, but particularly Black and Latino
people, as they will be relatable role models that the targeted population can
identify with. The use of relatable real young adults will improve the credibility
of the campaign and reduces the likelihood that the message will fall on deaf
ears. According to Silvia, increasing the credibility or attractiveness of a
messenger can increase the positive force toward compliance (13). Moreover, by
seeing the success stories of relatable young adults who avoided becoming
teenage parents, the teenagers can internalize the positive label this
intervention projects, and thus engage in the positive behaviors the
intervention aims to promote, as exemplified in the study of the students who
performed better on a test when reminded that they were Asian (8). Portraying
images of successful young people of color is powerful for the psyche of the
targeted population, where the definition of success is broad and encompasses but
is not limited to graduating from high school, being the first person in their
family to attend college, or getting a job. These positive labels counter the innumerable
other negative labels of minority youth that are spewed daily and empowers them
to believe they can achieve greatness.
Defense 2: Reframing Teenage Pregnancy as a Symptom of Poverty
The proposed intervention will reframe the HRA’s ads to
dispel stigma and myths related to teenage childbearing, and promulgate the
evidence-based concept that teenage pregnancy is a symptom of poverty, social
inequality, and economic immobility that society must address using a positive
approach. To counter the powerful damages on public perception of teenage
pregnancy from the HRA ad campaign, this proposed intervention will reframe
teenage pregnancy as a consequence of poverty using the same core value of
wealth to support the core position that as a society, we have a social
obligation to address the social and economic factors that lead to poverty and
provide support and resources to those affected by poverty and inequality, and
by doing so will contribute to the increased wealth of New York City as a
whole. Using powerful images of minority teens overcoming poverty with the help
of the city’s HRA social programs and using catchphrases that invoke feelings
of community spirit, unity and mentorship will help the frame invoke the core
values of wealth and community.
A key principle to reframing the previous intervention and
making it successful in reducing the teenage pregnancy rate is Maslow’s
hierarchy of needs. Maslow conceptualized that people are motivated to achieve
certain needs and once a need is fulfilled, the individual seeks to fulfill the
next one, and so forth. According to his model, physiological needs, like food
and water, are the most basic and that people are not as motivated to fulfill
their social needs of sexual intimacy, love and family because they are
higher-level needs and not as vital to survival. Therefore in a public health
setting, public health professionals must remember that health and sexual
intimacy are higher-level needs for vulnerable and poor populations, which
means that they are less of a priority for them (14). This intervention keeps
implication in mind and therefore uses reframing to address the poverty of the
targeted population in the hope that by providing information on how to access
the city’s social programs and other non-profit services, the targeted
population will be empowered to meet their basic physiological needs so that
they can then make informed health and social decisions.
Defense 3: Offering Alternative Aspirations and the Freedom
of Choice
The proposed intervention will work to decrease psychological
reactance to the confrontational messages of the previous campaign by changing
the message, tone and messenger of the campaign. As previously stated,
specifically using young people of color to relay the public health message,
will help the targeted population to identify with the young adult role models
who have achieved accomplishments by avoiding becoming a teenage parent. By
being exposed to someone who looks like them and who garnered freedom from
poverty by exercising their ability to choose how they will live their lives,
advocate for themselves and avoid being a teenage parent, then the targeted
minority youth will believe it is possible for them to achieve similar goals.
Keeping in mind that teenagers are often frustrated with constantly being told
what to do by parents, teachers, and consumer goods marketing campaigns, and
that teenagers have a tendency to react and rebel against these voices by doing
what they are told not to do, this campaign will restore the freedoms that were
previously threatened in the old campaign by ensuring that it is provides
teenagers with options and information on choices that they can decide for
themselves.
Time and time again, using statistics or facts about a public
health issue have been proven to be ineffective ways of framing a message that
is meant to influence behavior. The theory of optimistic bias,
which is based on the relationship between irrationality and risk, asserts that
people generally understand the risks of something in the general population,
but will tend to underestimate that risk for themselves. For example, people
who use mobile phones while driving tend to rationalize their unsafe behavior
by reassuring themselves that unlike the 27% of people who get into motor
vehicle accidents when using a mobile phone while driving, they will not crash
because they believe they are a good driver” (15). Therefore, in order to
combat optimistic bias and be more effective, campaigns should employ the use
of powerful individual stories that are relatable to the target audience,
rather than statistics. As opposed to using
statistics that were the focus of the previous campaign, such as “If you finish
high school, get a job, and get married before having children, you have a 98
percent chance of not being in poverty,” this ad campaign will present methods
and resources that teenagers can utilize to work towards their freedom through
a relatable messenger.
Conclusion
The failure of New York City’s HRA to conduct in-depth
research into the true association between poverty and teenage childbearing and
considering common social and behavioral theories of change prior to embarking
on their mass advertising campaign is ineffective in achieving the intended
outcome of the intervention: reducing teenage pregnancy. Instead, it is
promulgating falsehoods on the association between poverty and teenage
pregnancy; further stigmatizes teenage parents; causes psychological reactance
in teenagers by threatening their perceived freedoms; fails to provide
information or support for overcoming the socioeconomic inequities that drive
teenage pregnancy rates; and perpetuates racism on the institutional,
personally-mediated and internalized levels.
The
goal of this new campaign is to restore the freedom that was threatened in the
old campaign by empowering the teenagers to feel independent to make their own
decisions; using accomplished minority young adults to present teens with options
as a way of deflecting psychological reactance and minimizing optimistic bias; reframing
poverty to reflect the real facts and providing information and support to
address social and economic determinants of poverty; and ensuring that shame
and stigma is removed from the campaign and that the positivity of youth
empowerment will enable them to assert agency in their sexual behavior and
education.
REFERENCES
1.
Taylor
K. (2013). “Posters on Teenage Pregnancy Draw Fire.” The New York Times.
6 Mar. 2013. Web. http://www.nytimes.com/2013/03/07/nyregion/city-campaign-targeting-teenage-pregnancy-draws-criticism.html
2.
King
J. (2013). “New York City tries to chame its teens into not having babies.” Color Lines for Action. 6 Mar 2013. Web.
http://colorlines.com/archives/2013/03/new_york_city_tries_to_shame_its_teens_into_not_having_babies.html
3.
Human
Resources Administration Department of Social Services. (2014). HRA/DSS - About
Human Resources Administration/Department of Social Services. http://www.nyc.gov/html/hra/html/about/about.shtml
4.
Szalavitz
M. (2013). “Why New York’s Latest Campaign To Lower Teen Pregnancy Could
Backfire.” Time. 28 Mar 2013. Web. http://healthland.time.com/2013/03/28/why-new-yorks-latest-campaign-to-lower-teen-pregnancy-could-backfire/
5.
United
Nations Population Fund. (2013). “New York and Chicago Ad Campaigns Spur Debate
and Controversy in Push to Prevent Adolescent Pregnancy.” UNFPA News.27 Oct 2013. http://www.unfpa.org/public/cache/offonce/home/news/pid/15478;jsessionid=19C6EE1C492BE62CF1433D3B3081263A.jahia02#sthash.6wgpmGC6.dpuf
6.
Racialicious
– the intersection of race and pop culture. (2013). Controlling Portions,
Controlling Pregnancies: Race And Class Panic In New York City Public Health
Campaigns. 3 April 2013. http://www.racialicious.com/2013/04/03/controlling-portions-controlling-pregnancies-race-and-class-panic-in-new-york-city-public-health-campaigns/
7.
US
Department of Health and Human Services. (2011). New York Adolescent
Reproductive Health Facts. Office of Adolescent Health. http://www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/states/ny.html
8.
Siegel,
M. Lecture Notes. February 6, 2014.
9.
Kearney
MS, Levine PB. (2012). Why is the teen birth rate in the United States so high
and why does it matter? J Econ Perspect. 2012;26(2):141---166.
10. Driscoll, R., Davis, K.E., &
Lipetz, M.E. (1972). Parental interference and romantic love: The Romeo &
Juliet effect. Journal of Personality and Social Psychology, 24, 1-10
11. White, W. & Miller, W.
(2007). The use of confrontation in addiction treatment: History, science and
time for change. Counselor, 8(4), 12-30.
12. Siegel, M. Lecture Notes. March
20, 2014.
13. Silvia PJ.(2005). Deflecting
reactance: The role of similarity in increasing compliance and reducing
resistance. Basic and Applied Social Psychology 2005; 27:277-284.
14. Simply Psychology. (2014).
Maslow’s hierarchy of needs. Maslow. Web. http://www.simplypsychology.org/maslow.html
15. Siegel, M. Lecture Notes. April
10, 2014.
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