Office of Population Research, Center for Health and Wellbeing, Princeton University, Princeton, NJ 08544, USA.
Am J Public Health. 2012 Feb;102(2):359-67. doi: 10.2105/AJPH.2011.300380. Epub 2011 Dec 15.
We investigated determinants of and disparities in reproductive health service use among young women in the United States from 2002 to 2008.
Using data on 4421 US women aged 15 to 24 years from the National Survey of Family Growth (2002, n = 2157; 2006-2008, n = 2264), we employed descriptive and univariate statistics and multivariate regression models to examine service use across women's sociodemographic and reproductive characteristics and to investigate potential disparate changes in service use over time.
More than half the sample (59%) had used services in the past year. In regression models, predictors of service use included age, education, birthplace, insurance, religious participation, mother's education, childhood family situation, age at menarche, sexual intercourse experience, recent number of partners, and previous gynecological diagnosis. Although service use decreased by 8% overall from 2002 to 2006-2008 (P < .001), the magnitude of decline was similar across demographic and socioeconomic groups.
Inequalities in reproductive health service use exist among women in the United States, particularly among the youngest and socially disadvantaged women, which may translate to poor and disparate reproductive outcomes. Public health and policy strategies are needed to eliminate inequities in reproductive health service.
我们调查了美国年轻女性在 2002 年至 2008 年间生殖健康服务使用的决定因素和差异。
使用来自全国家庭增长调查（2002 年，n=2157；2006-2008 年，n=2264）的 4421 名年龄在 15 至 24 岁的美国女性的数据，我们采用描述性和单变量统计以及多变量回归模型，检查了女性社会人口统计学和生殖特征方面的服务使用情况，并调查了服务使用随时间变化的潜在差异。
超过一半的样本（59%）在过去一年中使用过服务。在回归模型中，服务使用的预测因素包括年龄、教育、出生地、保险、宗教参与、母亲的教育、童年家庭状况、初潮年龄、性经验、最近的伴侣数量以及以前的妇科诊断。尽管 2002 年至 2006-2008 年服务使用总体下降了 8%（P<0.001），但在人口统计学和社会经济群体中，下降幅度相似。
美国女性在生殖健康服务使用方面存在不平等现象，尤其是在最年轻和社会劣势的女性中，这可能会导致生殖结果不佳和差异。需要采取公共卫生和政策策略来消除生殖健康服务中的不平等。
