Characteristics of U.S. Abortion Patients Who Obtained Care Out of State Prior to the Overturning of Roe v. Wade

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-03-01 DOI:10.1016/j.whi.2023.10.003
Sarah M. Axelson MSW , Riley J. Steiner PhD, MPH , Rachel K. Jones PhD
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Abstract

Context

In light of the Dobbs v. Jackson Women's Health Organization decision overturning Roe v. Wade, the number of people who need to travel out of state for abortion is increasing as several states impose abortion bans. Better understanding the characteristics of patients who obtained out-of-state abortions before the decision can provide a reference point for future research and inform efforts to improve abortion access.

Methods

We used data from the 2014 Abortion Patient Survey, administered by the Guttmacher Institute, to examine the prevalence and characteristics of patients obtaining nonhospital abortions outside of their state of residence. We examined bivariate and multivariable associations between selected characteristics and obtaining an abortion out of state.

Results

Six percent of abortion patients traveled out of state for care. Among patients who obtained their abortion out of state, more than half (56.9%) were non-Hispanic (NH) white, 26.6% were non-Hispanic Black, and 10.2% were Hispanic. Two-fifths (43.9%) resided in the South, one-third (34.3%) resided in the Midwest, 15% resided in the Northeast, and 7% resided in the West. More than one-third (38.2%) had family incomes below 100% of the federal poverty level (FPL), and two-thirds (67.7%) paid out of pocket; only 3% used Medicaid. Profiles of out-of-state abortion patients differed from in-state abortion patients by all characteristics except age. In adjusted analyses, NH Black (adjusted odds ratio [AOR]: 0.76; 95% confidence interval [CI]: 0.61–0.96), NH Asian, South Asian, and Asian Pacific Islander (AOR: 0.37; 95% CI: 0.20–0.67), and Hispanic (AOR: 0.46; 95% CI: 0.33–0.64) patients had lower odds of traveling out of state compared with their NH white counterparts. Compared with those paying for their abortion with private insurance, those who paid out of pocket had higher odds of traveling out of state (AOR: 1.75; 95% CI: 1.29–2.37) and those paying with Medicaid had lower odds (AOR: 0.27; 95% CI: 0.15–0.47).

Conclusion

Given the observed differences by race/ethnicity and method of payment for abortion, people of color and those without resources to pay out of pocket may especially benefit from efforts to support access to abortion care via interstate travel as an increasing number of states ban abortion.

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罗伊诉韦德案被推翻前在州外接受治疗的美国堕胎患者的特征。
背景:鉴于多布斯诉杰克逊妇女健康组织案(Dobbs v. Jackson Women's Health Organization)的判决推翻了罗伊诉韦德案(Roe v. Wade),随着多个州实施堕胎禁令,需要到州外堕胎的人数正在增加。更好地了解在该判决之前在州外堕胎的患者的特征,可为今后的研究提供参考,并为改善堕胎途径提供依据:我们使用古特马赫研究所(Guttmacher Institute)管理的 2014 年堕胎患者调查数据,研究了在居住州外进行非医院堕胎的患者的患病率和特征。我们研究了所选特征与在州外进行人工流产之间的双变量和多变量关联:结果:6%的人工流产患者前往州外接受治疗。在州外堕胎的患者中,一半以上(56.9%)为非西班牙裔(NH)白人,26.6%为非西班牙裔黑人,10.2%为西班牙裔。五分之二(43.9%)居住在南方,三分之一(34.3%)居住在中西部,15%居住在东北部,7%居住在西部。超过三分之一(38.2%)的人家庭收入低于联邦贫困线(FPL)的 100%,三分之二(67.7%)的人自掏腰包,只有 3% 的人使用医疗补助。除年龄外,州外人工流产患者与州内人工流产患者的所有特征均有所不同。在调整后的分析中,与新罕布什尔州的白人患者相比,新罕布什尔州的黑人(调整后的几率比 [AOR]:0.76;95% 置信区间 [CI]:0.61-0.96)、新罕布什尔州的亚裔、南亚和亚太岛民(AOR:0.37;95% CI:0.20-0.67)以及西班牙裔(AOR:0.46;95% CI:0.33-0.64)患者出州旅行的几率较低。与使用私人保险支付人工流产费用的患者相比,自费患者出州旅行的几率更高(AOR:1.75;95% CI:1.29-2.37),而使用医疗补助支付的患者出州旅行的几率较低(AOR:0.27;95% CI:0.15-0.47):鉴于观察到的种族/民族差异和堕胎付款方式的不同,随着越来越多的州禁止堕胎,有色人种和没有自费资源的人群可能会特别受益于支持通过州际旅行获得堕胎护理的努力。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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