Disparities in Abortion Rates: A Public Health Approach

Abortion rates in the US vary widely, with lower rates among women of color and those with low incomes than among wealthy and White women. In 2008, there were 12 abortions per 1000 non-Hispanic White women of reproductive age, compared to 29 abortions per 1000 Hispanic women and 40 abortions per 1000 Black women. We investigate the causes of abortion disparities and argue in favor of an all-encompassing public health approach to remedy them [1-3].
People of color, those with lower incomes, and those with less education perform badly on a range of health metrics. The evidence demonstrating a higher prevalence of risky behaviors and poor health outcomes in low-SES and women of color should be interpreted as reflecting unfavorable social conditions rather than personal shortcomings [4-6].
In the most recent National Survey of Family Growth (NSFG), 14.1% of non-Hispanic white women who used contraception used condoms, compared to 19.5% of Hispanic women and 19.9% of Black women. When a person has a low income or belongs to a given race or ethnicity, they are less likely to adopt highly efficient contraceptive methods. Continued use of a preferred method of ontraception reduces the chance of an unintended pregnancy since quitting might lead to gaps in contraceptive use [7, 8].
Inequities in the onset of sexual activity and the use of contraceptives may be caused by prejudice and stress that low-SES persons and people of color encounter. Teenagers who live in areas with higher concentrations of poverty, teenage idleness, social instability, and low rates of working moms are at greater risk of having sexual contact. According to studies, women who aren’t sure if they want to have children are more prone to adopt ineffective methods of contraception or to skip using any at all [9, 10].
The discrepancies in unplanned pregnancies and the corresponding variations in contraception usage influence abortion rates. These outcomes are a direct result of structural issues, such as financial difficulty, neighborhood traits, and a lack of access to family planning. Access to contraceptive services may be made easier financially under the Affordable Care Act. It is necessary to conduct further study on how to help women make educated decisions about using contraceptives [1, 11].
In the US, preventing unintended pregnancies is just as crucial as reducing diabetes and other health inequities. To guarantee that women receive the greatest outcomes possible, high-quality pregnancy and abortion services must be accessible. Cost is a major barrier to accessing abortion services, especially for low-SES people. A second-trimester abortion was four times more likely for women who said they had trouble getting Medicaid coverage [12, 13].
In summary, there are huge variations in abortion rates in the US, with rates that are lower for women of color and those who are poor compared to rich and White women. We examine the factors that contribute to abortion inequities and make the case for a comprehensive public health strategy to address them. A person is less likely to use highly effective contraceptive techniques if they have a low income or are of a certain race or ethnicity. According to the National Survey of Family Growth, non-Hispanic White women used condoms at a rate of 14.1%, while Hispanic and Black women used them at a rate of 19.5% each.
Uncertain women are more prone to use less effective techniques or to altogether skip taking any kind of contraception. High-quality pregnancy and abortion services must be available to ensure that women get the best results possible.
References
[1] C. Dehlendorf, L. H. Harris, and T. A. Weitz, “Disparities in abortion rates: a public health approach,” American journal of public health, vol. 103, no. 10, pp. 1772-1779, 2013.
[2] J. Nelson, Women of color and the reproductive rights movement. NYU Press, 2003.
[3] J. Cleland, S. Bernstein, A. Ezeh, A. Faundes, A. Glasier, and J. Innis, “Family planning: the unfinished agenda,” The lancet, vol. 368, no. 9549, pp. 1810-1827, 2006.
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[7] J. C. Abma, Fertility, family planning, and women’s health: new data from the 1995 National Survey of Family Growth. National Ctr for Health Statistics, 1997.
[8] N. C. Liddon, J. S. Leichliter, and L. E. Markowitz, “Human papillomavirus vaccine and sexual behavior among adolescent and young women,” American journal of preventive medicine, vol. 42, no. 1, pp. 44-52, 2012.
[9]  M.-C. Boutrin and D. R. Williams, “What racism has to do with it: Understanding and reducing sexually transmitted diseases in youth of color,” in Healthcare, 2021, vol. 9, no. 6: Multidisciplinary Digital Publishing Institute, p. 673.
[10] B. R. Belz, “Investigating the Role of Implicit Class Bias in the Clinical Encounter: A Call to Eliminate Health Disparities (thesis),” 2020.
[11] C. D. Brindis, “A public health success: Understanding policy changes related to teen sexual activity and pregnancy,” Annu. Rev. Public Health, vol. 27, pp. 277-295, 2006.
[12] H. K. Bellanca and M. S. Hunter, “ONE KEY QUESTION : Preventive reproductive health is part of high quality primary care,” Contraception, vol. 88, no. 1, pp. 3-6, 2013.
[13] O. M. Campbell, W. J. Graham, and L. M. S. S. s. group, “Strategies for reducing maternal mortality: getting on with what works,” The lancet, vol. 368, no. 9543, pp. 1284-1299, 2006.

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