Guttmacher Institute, New York, NY, USA.
Guttmacher Institute, New York, NY, USA.
Lancet Public Health. 2017 Nov;2(11):e493-e500. doi: 10.1016/S2468-2667(17)30158-5. Epub 2017 Oct 3.
Abortion can help women to control their fertility and is an important component of health care for women. Although women in the USA who live further from an abortion clinic are less likely to obtain an abortion than women who live closer to an abortion clinic, no national study has examined inequality in access to abortion and whether inequality has increased as the number of abortion clinics has declined.
For this analysis, we obtained data on abortion clinics for 2000, 2011, and 2014 from the Guttmacher Institute's Abortion Provider Census. Block groups and the percentage of women aged 15-44 years by census tract were obtained from the US Census Bureau. Distance to the nearest clinic was calculated for the population-weighted centroid of every block group. We calculated the median distance to an abortion clinic for women in each county and the median and 80th percentile distances for each state by weighting block groups by the number of women of reproductive age (15-44 years).
In 2014, women in the USA would have had to travel a median distance of 10·79 miles (17·36 km) to reach the nearest abortion clinic, although 20% of women would have had to travel 42·54 miles (68·46 km) or more. We found substantially greater variation within than between states because, even in mostly rural states, women and clinics were concentrated in urban areas. We identified spatial disparities in abortion access, which were broadly unchanged, at least as far back as 2000.
We showed substantial and persistent spatial disparities in access to abortion in the USA. These results contribute to an emerging literature documenting similar disparities in other high-income countries.
An anonymous grant to the Guttmacher Institute.
堕胎可以帮助女性控制生育，是女性保健的重要组成部分。尽管美国居住在离堕胎诊所较远的女性获得堕胎的可能性低于居住在离堕胎诊所较近的女性，但没有全国性的研究调查过堕胎机会方面的不平等现象，也没有研究过随着堕胎诊所数量的减少，不平等现象是否有所增加。
在这项分析中，我们从盖特马赫研究所（Guttmacher Institute）的堕胎提供者普查（Abortion Provider Census）中获得了 2000 年、2011 年和 2014 年的堕胎诊所数据。街区组和每个普查区 15-44 岁女性的比例从美国人口普查局获得。为每个街区组的人口加权质心计算到最近诊所的距离。我们按生育年龄（15-44 岁）的女性人数对街区组进行加权，计算了每个县的女性到达最近堕胎诊所的中位数距离，以及每个州的中位数和 80 百分位距离。
2014 年，美国女性到达最近堕胎诊所的平均距离将达到 10.79 英里（17.36 公里），尽管 20%的女性将不得不行驶 42.54 英里（68.46 公里）或更远。我们发现，州内的差异远远大于州际之间的差异，因为即使在以农村为主的州，女性和诊所也集中在城市地区。我们发现堕胎机会方面存在广泛的空间差异，至少从 2000 年以来，这种差异基本保持不变。
我们在美国堕胎机会方面存在显著且持续的空间差异。这些结果为其他高收入国家记录类似差异的新兴文献做出了贡献。
盖特马赫研究所的一笔匿名赠款。
