Reducing health disparities by removing cost, access, and knowledge barriers

Abstract

CONDENSATIONBlack-white health disparities in the rate of unintended pregnancies can be reduced by providing education, reducing access barriers, and providing contraception at no cost. 2009, 2010, and 2011. We estimated an absolute measure (rate difference (RD)) and a relative measure (rate ratio (RR)) to examine Black-White disparities in the rates of unintended pregnancy.Results: While national rates of unintended pregnancy are decreasing, racial disparities in these rates persist. The Black-White rate difference dropped from 158.5 per 1,000 in 2008 to 120.1 per 1,000 in 2011; however, the relative ratio disparity decreased only from 2.6 to 2.5, suggesting that Black sexually active teens in the U.S.have 2.5 times the rate of unintended pregnancy as White teenagers. In the CHOICE Project, there was a decreasing trend in racial disparities in unintended pregnancy rates Draft 12/6/17 Unintended Pregnancies: Reducing Health Disparities Page | 4 among sexually active teens (age 15-19); RR=3.7), 2010 RR=1.2) and 2013-2014 (RD=-1.5; RR=1.0). Conclusions:When barriers to cost, access, and knowledge were removed, such as in the Contraceptive CHOICE Project, Black-White disparities in unintended pregnancy rates among sexually active teens are reduced on both absolute and relative scales.The rate of unintended pregnancy was almost equal between Black and White women compared to large Black-White disparities on the national level. Word Count: 343Draft 12/6/17

Access to choice: Examining differences between adolescent and adult abortion fund service recipients

“…This is not unexpected, given evidence indicating that economically disadvantaged women and women of colour are disproportionately impacted by unintended pregnancy (Lara, Holt, Pena, & Grossman, ). Additionally, evidence suggests that people of colour have high rates of economic vulnerability and elevated rates of abortion, Black adolescent perceptions about contraceptive use can vary as a result of these various disadvantages, and unintended pregnancy is higher for Black adolescents in comparison to White adolescents (Barr, Simons, Simons, Gibbons, & Gerrard, ; Dehlendorf et al., ; Goodman, Onwumere, Milam, & Piepert, ). Moreover, adolescents of colour and those from disadvantaged backgrounds are known to experience serious disparities in access to family planning and reproductive healthcare services (Coles, Makino, & Stanwood, ).…”

“…Black adolescent perceptions about contraceptive use can vary as a result of these various disadvantages, and unintended pregnancy is higher for Black adolescents in comparison to White adolescents (Barr, Simons, Simons, Gibbons, & Gerrard, 2013;Dehlendorf et al, 2013;Goodman, Onwumere, Milam, & Piepert, 2017). Moreover, adolescents of colour and those from disadvantaged backgrounds are known to experience serious disparities in access to family planning and reproductive healthcare services (Coles, Makino, & Stanwood, 2011).…”

Socioeconomic Status As a Risk Factor for Unintended Pregnancy in the Contraceptive CHOICE Project

“…(17,18,19,20) Several studies have illustrated that when barriers to cost, access and knowledge are removed, black-white disparities in unintended pregnancy among sexually active teens and women were reduced. (5,15,21) By adapting a client-centered approach for counseling teens and women, ensuring the most effective contraceptive methods are discussed with each patient, and adapting programs to help subsidize the provision of these methods, it is possible that unintended pregnancy rates across all ages, ethnic and socioeconomic statuses will continue to decline. (7,8,15)…”

Could the Maternal Ethnicity to be a Determinant in the Healthcare Cost of Assistance at Birth?

“…Of interest, the findings in U.S. by Zang et al [11] are conclusive for higher costs in American, more likely to have a cesarean section (CS), to stay longer in the hospital, to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. In a different study on American population, Goodman and co-workers focused on disparities in unintended pregnancy rates between Black and White teens age 15-19 years sexually active, finding reduced absolute and relative scales, if barriers to cost, access, and knowledge were removed [12]. As consequence, ethnic disparities in adverse pregnancy outcomes represent not only potentially preventable human suffering, but also avoidable economic costs.…”