Between 1990 and 1997 teen pregnancy and birth rates have fallen dramatically, especially in black teens. However, the teen birth rate in the United States remains the highest of any industrialized nation: four times higher than Germany, six times higher than France. Contraception use has also increased. Condoms were used during last intercourse approximately 55% of the time in 1997 vs. only approximately 38% in 1991. Likewise, the percentage of teens having intercourse has dropped, and the number of abortions is down. The negative social and economic impact of early teenage pregnancy is tremendous. It is estimated to cost the nation about $21 billion annually (in 1993 dollars). The long-term productive life prospects are also lower for teenage mothers and their offspring. Many programs have been utilized to reduce the incidence of teen pregnancy. While some have had modest success, no single or simple solution is on the horizon.