Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, United States.
JMIR Public Health Surveill. 2024 Nov 6;10:e60001. doi: 10.2196/60001.
Crisis pregnancy centers (CPCs) are religious nonprofit organizations with a primary mission of diverting people from having abortions. One CPC tactic has been to locate near abortion facilities. Despite medical groups' warnings that CPCs do not adhere to medical and ethical standards and pose risks, government support for CPCs has significantly increased.
This study aims to map CPCs, abortion facilities, and geographical areas in the United States into 4 zones based on their proximity to CPCs and abortion facilities. We sought to describe the number and percentage of reproductive-aged women living in each zone and the proximity of CPCs to abortion facilities.
Using 2021 data from CPC Map and the Advancing New Standards in Reproductive Health Abortion Facility Database, we determined the ratio of CPCs to abortion facilities. Along with census data, we categorized and mapped US block groups into 4 distinct zones based on locations of block group centroids within 15-mile (1 mile is approximately 1.609 km) radii of CPCs and abortion facilities, namely "no presence," "CPC only," "abortion facility only," and "dual presence." We calculated the number and percentage of block groups and reproductive-aged (15-49 years) women living in each zone. We calculated driving distances and drive times from abortion facilities to the nearest CPC and mapped abortion facilities with CPCs in close proximity. All analyses were conducted nationally and by region, division, and state.
Nationally, the ratio of CPCs to abortion facilities was 3.4, and 54.9% (131,410/239,462) of block groups were categorized in the "dual presence" zone, 26.6% (63,679/239,462) as "CPC only," and 0.8% (63,679/239,462) as "abortion facility only." Most reproductive-aged women (45,150,110/75,582,028, 59.7%) lived in a "dual presence" zone, 26.1% (19,696,572/75,582,028) in a "CPC only" zone, and 0.8% (625,403/75,582,028) in an "abortion facility only" zone. The number of block groups and women classified as living in each zone varied by region, division, and state. Nationally, the median distance from abortion facilities to the nearest CPC was 2 miles, and the median drive time was 5.5 minutes. Minimum drive times were <1 minute in all but 11 states. The percentages of abortion facilities with a CPC within 0.25, 0.5, 1, and 3 miles were 14.1% (107/757), 22.6% (171/757), 36.1% (273/757), and 66.3% (502/757), respectively.
The findings suggest that CPCs' tactic of locating near abortion facilities was largely realized before the 2022 US Supreme Court decision that overturned the federal right to abortion. Research on CPCs' locations and tactics should continue given the dynamic abortion policy landscape and risks posed by CPCs. Tailored programming to raise awareness about CPCs and help people identify and access safe sources of health care may mitigate harm. Increased regulation of CPCs and government divestment may also mitigate CPC harms.
危机怀孕中心（CPC）是宗教非营利组织，其主要使命是劝阻人们堕胎。CPC 的策略之一是在堕胎设施附近选址。尽管医疗团体警告说 CPC 不遵守医疗和伦理标准，并存在风险，但政府对 CPC 的支持却大幅增加。
本研究旨在根据 CPC 和堕胎设施的接近程度，将美国的 CPC、堕胎设施和地理区域划分为 4 个区域。我们旨在描述生活在每个区域的育龄妇女数量和比例，以及 CPC 与堕胎设施的接近程度。
利用 2021 年 CPC Map 和生殖健康堕胎设施数据库中的数据，我们确定了 CPC 与堕胎设施的比例。结合人口普查数据，我们根据街区组质心在 15 英里（1 英里约为 1.609 公里）半径内的位置，将美国街区组划分为 4 个不同的区域，分别是“不存在”、“仅 CPC”、“仅堕胎设施”和“双重存在”。我们计算了每个区域的街区组和育龄妇女（15-49 岁）的数量和比例。我们计算了从堕胎设施到最近 CPC 的驾驶距离和驾驶时间，并绘制了与 CPC 近距离的堕胎设施地图。所有分析均在全国范围内以及按地区、分区和州进行。
在全国范围内，CPC 与堕胎设施的比例为 3.4，54.9%（131410/239462）的街区组被归类为“双重存在”区域，26.6%（63679/239462）为“仅 CPC”区域，0.8%（63679/239462）为“仅堕胎设施”区域。大多数育龄妇女（45150110/7558208，59.7%）生活在“双重存在”区域，26.1%（19696572/7558208）生活在“仅 CPC”区域，0.8%（625403/7558208）生活在“仅堕胎设施”区域。按区域、分区和州划分，每个区域的街区组和妇女数量存在差异。在全国范围内，从堕胎设施到最近 CPC 的中位数距离为 2 英里，中位数驾驶时间为 5.5 分钟。除了 11 个州之外，最短驾驶时间都<1 分钟。距离堕胎设施 0.25、0.5、1 和 3 英里以内的堕胎设施中 CPC 的比例分别为 14.1%（107/757）、22.6%（171/757）、36.1%（273/757）和 66.3%（502/757）。
研究结果表明，CPC 选址靠近堕胎设施的策略在 2022 年美国最高法院推翻联邦堕胎权的裁决之前就已基本实现。鉴于动态的堕胎政策格局和 CPC 带来的风险，应继续研究 CPC 的位置和策略。提高对 CPC 的认识，并帮助人们识别和获得安全的医疗保健资源的定制方案，可能会减轻伤害。增加对 CPC 的监管和政府撤资也可能减轻 CPC 带来的危害。
