There is growing concern among program providers and policymakers that large numbers of our nation’s adolescents—particularly young girls between the ages of 10 and 15—are at great risk for a number of problems including pregnancy, alcohol and drug abuse, and school failure. Many of these young teens live in poor neighborhoods. According to the 1992 Current Population Survey (CPS), there were over 7 million girls under 18 years old living in poverty, with over 2.5 million residing in poor neighborhoods. In addition, as many as half of all adolescents aged 10 to 15 are reported to be at moderate or high risk of school failure, early sexual activity, drug and alcohol use, or criminal behavior. Among the most far reaching and costly of all negative outcomes for young at-risk girls is early parenthood. In 1990, about 361,000 babies were born to unmarried teenagers—approximately 9 percent of all births in that year. From 1960 to 1992, the birth rate for all teens increased from 15.3 to 44.6 births per thousand. While the number of births to the very young—aged 15 and younger—is not large, this group is experiencing the greatest rate of increased births. Pregnancy rates for all girls under 15 years old rose 4.1 percent in the United States during the period between 1980 and 1988—higher than any other teen age group. In addition, these young mothers often have other characteristics that are associated with long-term welfare dependency and other long-term problems, such as deficient education and employment skills and histories of child abuse and neglect. The public costs of teen mothers are high. According to the most recent Census data available, nearly one-half of all women receiving AFDC from 1976 to 1992 were or had been teenage mothers (see fig. 1). In addition, these women were more likely to be the least educated and have larger families, thus making them the least likely to leave AFDC and become self-sufficient. The Center for Population Options estimated that in 1992 the federal government spent over $34 billion on AFDC, Medicaid, and Food Stamps to support families begun by teens. Generally, teen pregnancy prevention projects have produced less than encouraging results, whether programs were targeted to prevent teens from their first pregnancy or additional pregnancies. For example, the Office of Technology Assessment (OTA) reviewed pregnancy prevention programs that attempted to (1) increase teens’ knowledge about reproduction, (2) improve access to contraceptives, or (3) broaden teens’ life options. OTA concluded that despite some promising approaches, no evidence existed of significantly reduced pregnancy rates among teen girls when the approaches were applied independently. Intervening after teens have become sexually active or after they have given birth appears to be too late for positive impacts, regardless of the type of program. For example, a national demonstration project that provided education and employability development as well as other supportive services to teen mothers was unsuccessful at reducing the rate of second pregnancies among teen mothers. The developers of this effort recognized the difficulty of overcoming “serious obstacles to advancement, some psychological in nature, others related to dysfunctional families, dangerous schools and neighborhoods, and other factors in their social, physical, and economic environments.” Historically, federal initiatives to address the individual problems of youths, their families, and teen pregnancy have generally resulted in “single-problem” programs and reactive, crisis-oriented service strategies by local providers. A Congressional Research Service (CRS) study concluded that some federal programs aimed at reducing the incidence of teen pregnancy disagree on the federal role, resulting in a patchwork of differing goals ranging from promoting abstinence to encouraging the use of pregnancy planning among sexually active teens. Consequently, federal programs often support local projects that target one of these goals at the exclusion of others. In neighborhoods with high concentrations of poor families, many 10- to 15-year-old girls have multiple problems. The combination of abuse and neglect in young teens’ households and dangerous and decaying neighborhoods has increased the numbers of young teen girls with the risk characteristics associated with long-term welfare dependency, education deficits, and early parenthood. These girls are growing up under circumstances that often compromise their health, impair their sense of self, limit their development potential, and generally restrict their chances for independent and productive lives. In the neighborhoods we visited, family poverty combined with parental substance abuse and sexual or physical abuse of children makes growing up a significant challenge for many young girls. Many of the girls in these communities lived in households where the income was below the poverty level. In Washington, D.C.’s, Ward 7, for example, according to the 1990 census, 18 percent of the households were considered to be poor. In addition, many of the girls in the communities we visited lived in single-parent households, typically headed by their mothers. These households, as characterized by providers, lacked parental supervision and left young girls isolated from family members as well as from their neighborhoods. The principal of a middle school in West Oakland told us that many of her female students’ parents were abusing drugs or alcohol, and crime and violence proliferated in their neighborhoods; one or both parents were often absent; and many of the adults in the homes did not have the skills and abilities to function as parents. Families living in poverty are stressed and constrained by the normal activities of daily life, which can make parents and children feel hopeless and helpless. In our interviews with service providers and our reviews of recent studies, we found (1) high rates of substance abuse among the parents of young teen girls, (2) widespread physical and sexual abuse of teen girls, and (3) many young girls that were left unattended for long periods of time and who often assumed adult responsibilities in their homes. Factors associated with family dysfunction, such as substance abuse, were prevalent in all the communities we visited. Nationally, rates of drug and alcohol abuse among women living in poverty and AFDC recipients, for example, have been estimated to range from more than 15 percent to almost 30 percent. Drug and alcohol abuse among parents was seen as a widespread, serious problem by many neighborhood providers, as well as by the young teen girls themselves. For example, in the West Oakland neighborhood we visited, the arrest rate for narcotics was more than double that for all of Oakland. Boyle Heights in Los Angeles registered almost three times the rate of alcohol-related arrests as Los Angeles as a whole between 1991 and 1993. The Ward 7 community was no different. The Director of Recreation for Washington, D.C., said that many of the young girls the Department of Recreation serves witness daily alcohol and drug abuse. Physical and sexual abuse were also reported by community providers as significant problems. In West Oakland, where the reported number of sexual abuse incidents rose from 49 in 1992 to 91 in 1993, the Adolescent Family Life Director believed that as many as 65 percent of the young girls the office serves have been sexually abused. Some providers reported that young victims of abuse—characteristically passive, lacking self-esteem, and pressured into early sex by extended family members and older men—have few options or role models and often follow what are seen as common practices in their neighborhoods. Providers in residential care facilities for parenting teens reported that most of their clients were victims of abuse. Recent research confirms their observations. Studies reported that as many as 68 percent of teen mothers were sexually abused as children. According to community providers, young girls are often unsupervised or on their own for extended periods of time and essentially parenting themselves, which isolates them from their families and communities and makes them vulnerable to outside influences. Local providers believed that many of these girls become the functioning adult in the household and assume the responsibility of caring for younger family members. The condition of the neighborhoods where these girls live induces fear and apprehension throughout the community. Their high crime rate, deteriorating infrastructure, and scarcity of commercial ventures threatens neighborhood children and provides them with few positive examples of future livelihoods. The areas we visited also had high numbers of declining public and private residential housing units. Each of these areas started out as a vibrant section of the city, but a variety of socioeconomic factors over time has caused these areas to deteriorate, leaving vacant and dilapidated buildings and reduced community resources. (Fig. 2 contains photographs of the neighborhoods we visited.) Crime is an important contributor to the destruction of a community. Young teen girls in the neighborhoods we visited feared for their safety and saw few places of refuge. In Boyle Heights, gang violence is a serious problem. Providers told us that the approximately 30 gangs in the area had a membership of about 15,000. In 1993, the police reported 763 gang-related crimes in the Boyle Heights area alone. Service providers told us that the teen girls in the area are at risk of joining gangs—one provider estimated that about 60 percent of the teen girls are already in gang-related activities. Although gang-related crimes were not reported to be high in Washington, D.C., the homicide rate in 1993 for Ward 7 was more than double that for the whole city. The girls we spoke with said that they feared going outside and preferred to stay at home. One girl told us that she feels “paranoid . . . wondering which way the bullet will go.” The physical and economic infrastructure of the neighborhoods we visited paralleled the social conditions. The neighborhoods were characterized by high numbers of public housing units—Washington, D.C.’s Ward 7 had the highest concentration of public housing units in the city. This neighborhood once had a solid middle-class residential and small business presence. Today, although the area continues to be residential with over 70,000 residents, 25.8 percent of the households were poor in 1990. In addition, although the area once had a substantial number of small businesses and stores, it now has no restaurants, except for fast-food places, and few opportunities for cultural activities. Boyle Heights, once an affluent suburb, is a mixture of aging commercial and industrial sections and subsidized housing.