Contraceptive Access Policies as a Gateway to Improved Health and Equity

Quality preventive medical care remains one of the most important tools for mitigating diseases like cancer, hypertension and heart disease, which are leading causes of death and disability in the U.S. However, due to persistent social and economic inequities, preventive services remain inaccessible to many people.

To close these gaps, researchers and primary care providers point to contraceptive care visits as a potential “window of opportunity” for general health promotion, education, and prevention. Contraceptive methods are utilized by 60 percent of women of reproductive age (15-44 years) in the U.S., and by nearly all sexually active women in the U.S. at some point in their lives. As such, contraceptive care can act as a vital gateway to other preventive health services.

Given this link, contraceptive access policy may have inadvertent consequences for preventive health service use, particularly for individuals who face other barriers to accessing care. Research in this area is being conducted on national policies like Medicaid family planning expansion or contraceptive coverage mandates, but less attention has been paid to other contraceptive access policies enacted at the state level, such as family planning funding restrictions, provider contraceptive service refusal, and nurse authority to prescribe and administer contraceptive services.

In this project, the research team will create a contraceptive access policy surveillance dataset and merge it with existing preventive health service utilization data to answer the following:

1. What is the relationship between cumulative state contraceptive access policies and health care utilization and outcomes (well-visits, screenings, STI diagnoses, diabetes, hypertension, etc.) of reproductive age individuals over a 10-year period?
2. What are the differential associations between cumulative state contraceptive access policies and health care utilization and outcomes by race, ethnicity, and socioeconomic status over a 10-year period?

Contraceptive access is an ongoing and prominent topic of U.S. policy discussion. The effect of contraceptive access policy on preventive health service use and outcomes, and these policies’ implications for health equity are vital pieces of inquiry to inform that discussion.