In 1988, the South Carolina legislature passed the Comprehensive Health Education Act (CHEA) which was designed to standardize health education instruction in the state in order to “reduce substantially the amount of money the state spends to care for teenage mothers and their often sickly babies.” We can argue about the language and motives behind the legislation but the process of standardizing how young people learn about health is an important one that many states still have not undertaken.
South Carolina was certainly ahead of the curve passing such a bill so long ago (I was still in high school in 1988), but 25 years later there are questions as to how effective the law has been since sexual health statistics show South Carolina struggling with teen birth rates and sexually transmitted disease (STD) rates higher than the national average.
A new report assesses the current status of health education with a focus on the reproductive health component. A Sterling Opportunity: 25 Years After the Comprehensive Health Education Act was conducted by Health Advocates LLC and the New Morning Foundation using a Department of Education survey of school districts in the state. The authors wanted to determine whether districts were following the parameters of the CHEA, what they were teaching, how well those teaching the subject were trained, and what materials they were using. The authors found a number of places where schools were failing to follow the law and providing inadequate — and in some cases inaccurate and outdated — information to students.
While the findings are not as outrageous as some found in other states, they shed important light on the situation in South Carolina which is struggling with a few issues: a law that has some good components and some highly restrictive ones, misunderstandings about what the law does and doesn’t require, and a complete lack of accountability.
The CHEA is very prescriptive in what is required as well as what is prohibited in health education including reproductive health education and teen pregnancy prevention. For example, it requires that each year students in grades nine through 12 receive comprehensive health education that includes at least 750 minutes of reproductive health education and pregnancy prevention education. Sixth through eighth graders are also supposed to receive reproductive health education which must include STD information. It may also include information on contraception, though this is up to the local school board.
The law does restrict sexuality education to a certain extent. It requires an emphasis on abstinence, says that contraception information must be provided in the context of future planning, and directs schools to present adoption as a “positive alternative.” In addition, schools cannot provide any information about abortions, distribute contraception of any kinds, or show films that portray actual or simulated sexual activity. Finally (and I’d argue most disturbingly), the law states that “health education classes may not include discussions of alternate sexual lifestyles from heterosexual relationships” except in the context of STDs.
Despite these conservative aspects, the sexuality education component of the law has been controversial since the law was passed. In fact, there have been a number of attempts to change that part of the law. The report notes one amendment to the law proposed in 1998 that sought to change the purpose of the CHEA from “promote responsible sexual behavior,” to “the goal of this act is to reduce the incidence of sexual activity among school aged youth.” In 2004, there was an attempt to reduce the amount of sex education instruction from a minimum of 750 minutes per year to a maximum of 200 minutes. These challenges have failed.
The law also has administrative aspects such as teacher training requirements; an “opt-out” provision that allows parents to remove their children from the reproductive health portion of the course; and a requirement that districts assemble an advisory board of parents, teachers, and clergy to review materials.
Even though the law remains in place, according to the report many school districts are not following it. In fact, the study found that 75 percent of the districts surveyed were out of compliance with some piece of the reproductive health portion of the CHEA.
Schools were out of compliance on issues related to time spent on reproductive health, teacher training, and administration. For example:
- 66 percent of districts that responded did not teach STD and HIV prevention in all three middle school grades.
- 23 percent of districts that responded did not have the appropriate community members on their advisory boards.
- 12 percent of districts that responded did not provide the required teacher training.
Interestingly, 96 percent of districts that responded reported teaching all 750 required minutes of reproductive health in high school.
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