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Principal Investigator: Christie Sennott
Organization: PURDUE UNIVERSITY
Fiscal Year: 2024
Award: $276,622
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Modified Project Summary/Abstract Section
Access to reproductive healthcare in the U.S. has become increasingly constrained. Although a growing body of research has focused on identifying state-level policies that affect access to care, less attention has been paid to documenting access to reproductive healthcare at the local level. Understanding how individuals and local communities experience changes in access to care necessitates a finer-grained measure than the state level, although no data currently exist that would allow for such an approach. Therefore, the primary goal of the proposed project is to create a new comprehensive longitudinal (2009-2021) dataset that will allow us to identify spatial variation in access to contraceptive, maternity, and abortion care at the U.S. county-level. We will use the new dataset to identify “reproductive healthcare deserts” (RHD), or counties where access to contraceptive, maternity, and abortion services is limited or nonexistent, document how access has changed over time, and examine how local access shapes health outcomes. To create this unique dataset, we will integrate data sources on (a) access to publicly funded contraceptive care at Title X clinics from the Office of Population Affairs and at Federally Qualified Health Centers from the Centers for Medicare & Medicaid Services; (b) access to maternity care from the Health Resources and Service Administration; and (c) access to abortion care from the Myers Abortion Facility Database. We will also create an interactive dashboard that will map the RHD dataset and include time-varying county-level characteristics obtained from supplementary datasets (e.g., American Community Survey). The dashboard will guide our descriptive research into the spatial patterns and scale of changes to reproductive healthcare access over the study period and highlight variation in access among individuals and communities. We will merge the RHD dataset with restricted-use data from the National Vital Statistics System and the National Survey of Family Growth to develop spatially clustered multilevel models analyzing the relationship between county-level reproductive healthcare access and individual-level measures of maternal morbidity, infant health, interbirth intervals, contraceptive use, and unintended birth. Taken together, this project will provide a new comprehensive measure of reproductive healthcare, a novel dataset and interactive dashboard that will track changes over a 13-year period, and robust evidence of how reproductive healthcare deserts are related to reproductive autonomy and maternal and infant health.
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