Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States; Population Research Center, The University of Texas at Austin, Austin, TX, United States.
Population Research Center, The University of Texas at Austin, Austin, TX, United States.
Contraception. 2022 Apr;108:19-24. doi: 10.1016/j.contraception.2021.11.003. Epub 2021 Dec 29.
To assess the association between indicators of economic disadvantage and geographic accessibility of reproductive health services and abortions ≥ 12 weeks' gestation in Mississippi.
This cross-sectional study used data on Mississippi residents who obtained abortion care from 12 of 14 facilities in Mississippi, Alabama, Louisiana, and Tennessee in 2018. We estimated logistic regression models to assess the association between levels of county deprivation, the number of obstetrician and/or gynecologists per 10,000 women, and one way distance to the nearest facility with having an abortion ≥ 12 weeks' gestation. We compared the median one-way distance to the facility where patients < 12 weeks', 12-15 weeks', and ≥ 16 weeks' gestation received care, using Kruskal-Wallis tests.
Of the 4,455 Mississippi residents who obtained abortions, 73% were Black, 59% lived ≥ 50 miles from a facility, and 60% obtained care in Mississippi. Overall, 764 (17.2%) abortions were performed ≥ 12 weeks' gestation. In adjusted models, those in counties with moderate (OR, 1.47; 95% CI: 1.15-1.90) and high (OR: 1.36, 95% CI: 1.01-1.83) (vs low) levels of economic deprivation and counties with 0.1-1.4 (vs ≥ 2.5) obstetrician/gynecologists per 10,000 women (OR: 1.55; 95% CI: 1.06-2.27) had higher odds of obtaining an abortion ≥12 weeks' gestation. Mississippi residents who obtained abortions ≥ 16 weeks' gestation traveled a median 143 miles one way to the facility where they received care, compared to 69 miles and 60 miles traveled by those < 12 weeks' and 12-15 weeks' gestation, respectively (p < .001).
Many Mississippi residents obtained abortion care ≥ 12 weeks' gestation, which is related to greater economic constraints and limited geographic access to reproductive health services.
People's need for abortions ≥ 12 weeks' gestation may be higher in communities with limited access to reproductive health services and among those living in areas with greater economic disadvantage. State laws that narrow gestational limits would increase long-distance travel for later abortion care, and disproportionately affect those with fewer resources.
评估密西西比州生殖健康服务和 12 周以上堕胎的经济劣势指标与地理可达性之间的关联。
本横断面研究使用了 2018 年从密西西比州、阿拉巴马州、路易斯安那州和田纳西州的 14 家机构中获得堕胎护理的密西西比州居民的数据。我们使用逻辑回归模型来评估县贫困程度、每 10000 名妇女的妇产科医生数量以及到最近堕胎设施的单程距离与 12 周以上堕胎之间的关系。我们使用 Kruskal-Wallis 检验比较了接受 12 周以下、12-15 周和≥16 周妊娠护理的患者到设施的中位数单程距离。
在 4455 名接受堕胎的密西西比州居民中，73%为黑人，59%居住在距离堕胎设施≥50 英里的地方，60%在密西西比州接受护理。总体而言，有 764 例（17.2%）堕胎在 12 周以上进行。在调整后的模型中，那些处于中度（OR，1.47；95%CI：1.15-1.90）和高度（OR：1.36，95%CI：1.01-1.83）（与低度）经济贫困水平的县和每 10000 名妇女有 0.1-1.4（与≥2.5）名妇产科医生（OR：1.55；95%CI：1.06-2.27）的县获得 12 周以上堕胎的几率更高。获得 16 周以上堕胎的密西西比州居民前往接受护理的设施单程中位数为 143 英里，而 12 周以下和 12-15 周妊娠的患者分别为 69 英里和 60 英里（p<.001）。
许多密西西比州居民获得了 12 周以上的堕胎护理，这与更大的经济限制和生殖健康服务的有限地理可及性有关。
在生殖健康服务获取途径有限的社区和经济劣势较大的地区，人们对 12 周以上堕胎的需求可能更高。限制妊娠时间的州法律将增加后期堕胎护理的长途旅行，并不成比例地影响资源较少的人。
