For years, Mississippi has had one of the highest rates of teen pregnancy in the nation. But as a deeply religious state where sex was a taboo subject, there wasn't much support for teaching about sex in schools.
As an article in the Los Angeles Times details, the issue of sex education has a long and contentious history in Mississippi. A bill that would require sex education to be taught failed in 2009, for example.
But in 2011, the Mississippi Legislature passed and Gov. Haley Barbour signed a law requiring all school districts to adopt a policy for teaching about sex. So what changed?
It wasn't the data about teen pregnancy - that had been circulating for awhile. In 2009, for example, the birthrate for women 19 or younger was 64.1 per 1,000 infants, compared with 39 out of every 1,000 nationally. What proved convincing, ultimately, was the data about how much money the state was losing because of its high teen pregnancy rate.
"They were saying, 'How do we get this state economically competitive?' And they identified teen pregnancy as an important problem to focus on," said Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy. "It was about economic competitiveness and overall child and family well-being - issues people tend to feel passionately about."
The numbers - in a state that has one of the highest poverty rates in the nation - were sobering. In 2009, teen births in Mississippi cost taxpayers $154.9 million, according to a report from the Mississippi Economic Policy Center.
Those costs include lost revenue from lower wages among teen parents, incarceration costs for the children of teen parents, and foster care costs, according to the report. Though lost wages and incomes of mothers who do not finish school because of pregnancy contribute to that figure, one of the biggest costs associated with teen childbearing is the poor outlook for teen parents' offspring, who often need public assistance, the report said.
The teen pregnancy bill got traction when it became clear that the state was having trouble attracting businesses because its educational levels were so low - in part because teenage parents often drop out of school, said Dr. Freda Bush, a gynecologist on the governor's Blue Ribbon Teen Pregnancy Task Force. Census data show that 29% of working-age adults in Mississippi have at least a two-year degree, compared with a national average of 38%.
"I think we have a pretty progressive governor as far as trying to improve the economics of the state," Bush said. "He said, 'If we can raise the educational level, then that makes it more inviting for businesses to come to the state.' "
Sanford Johnson saw firsthand how talking about economics could make skeptical school boards decide to teach about sex. As deputy outreach coordinator with Mississippi First, an education policy group, he traveled to counties around the state to try to get them to adopt a curriculum that would teach kids about contraceptives, as well as about abstinence. He would show counties their teen pregnancy rates, and rates of sexually transmitted infections, and then show how much this was costing.
"We're able to say that it's a health problem, academic problem, also an economic problem," he said.
In Tunica County, there are an average of 91.7 live births per 1,000 females to teenage girls each year, compared with 39 per 1,000 in the rest of the country. It had the highest teen birthrate of any county in Mississippi from 2005-09. The cost to taxpayers was $713,115, Johnson said.
That same amount of money, Mississippi First calculated, could pay for preschool for 191 children, two-year college for 390 students, or hire 22 police officers, 17 teachers or 12 registered nurses.
"A lot of districts are cash-strapped," Johnson said. "If you can say, 'That dollar you wish you had for pre-K, you don't have it because it went to teen pregnancy,' it shows if you're not addressing the issue. You're going to pay for it."