Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States; Collaborative for Reproductive Equity (CORE), University of Wisconsin-Madison, Madison, WI, United States.
Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States.
Contraception. 2022 Nov;115:22-26. doi: 10.1016/j.contraception.2022.07.014. Epub 2022 Aug 6.
This study assessed a broad array of socioeconomic barriers in relation to preferred contraceptive use during a time of exacerbated personal and social financial strain (the COVID-19 pandemic).
Using statewide data collected in early 2021 through the Survey of the Health of Wisconsin, we conducted bivariate analyses exploring the relationship between socioeconomic resources and preferred contraceptive use among Wisconsin women.
The survey garnered 1889 responses, with a response rate of 34%. The sample for the current study (N = 247) included only adult women of reproductive age who reported current contraceptive use. Nearly one-third (32.8%) of contraceptive users reported that they were not using their preferred method. We found that greater resource deprivation, including housing instability (had to relocate: p = 0.004; unable to pay rent and/or mortgage: p = 0.008), food insecurity (ran out of food: p = 0.003; worried about running out of food: p = 0.008), and greater financial stress (p < 0.001), were significantly associated with lowered likelihood of using one's preferred contraceptive method.
Findings indicated that people lacking socioeconomic resources, including adequate food and housing, may be unable to access their preferred contraceptive method(s). Amidst competing demands on time and resources, the inability to obtain preferred contraceptive method(s) may represent system-wide barriers as well as people's lowered ability to prioritize and access care in light of socioeconomic struggles.
Health care providers and health systems should work to address structural barriers to care and bolster community resources in ways that promote patients' reproductive autonomy. There is also a need for continued research on specific socioeconomic determinants of preferred contraceptive use and potential solutions that bolster community resources.
本研究评估了在个人和社会经济压力加剧时期（COVID-19 大流行期间）与首选避孕措施使用相关的广泛社会经济障碍。
使用 2021 年初通过威斯康星州健康调查收集的全州数据，我们进行了单变量分析，探讨了威斯康星州女性的社会经济资源与首选避孕措施使用之间的关系。
该调查共收到 1889 份回复，回复率为 34%。本研究的样本（N=247）仅包括报告当前使用避孕措施的成年育龄妇女。近三分之一（32.8%）的避孕使用者表示他们没有使用自己首选的方法。我们发现，资源匮乏程度更高，包括住房不稳定（不得不搬迁：p=0.004；无法支付租金和/或抵押贷款：p=0.008）、食物不安全（食物用尽：p=0.003；担心食物用尽：p=0.008）和更大的经济压力（p<0.001），与使用首选避孕方法的可能性降低显著相关。
研究结果表明，缺乏社会经济资源的人，包括充足的食物和住房，可能无法获得他们首选的避孕方法。在时间和资源竞争的情况下，无法获得首选避孕方法可能代表了系统层面的障碍，以及人们在面临社会经济困难时降低了优先考虑和获得护理的能力。
医疗保健提供者和医疗系统应努力解决护理方面的结构性障碍，并通过促进患者的生殖自主权来加强社区资源。还需要继续研究首选避孕措施使用的具体社会经济决定因素和加强社区资源的潜在解决方案。
