USING THE SOCIAL VULNERABILITY INDEX AND ABORTIONFINDER.ORG TO DETERMINE THE RELATIONSHIP BETWEEN SOCIAL VULNERABILITY AND SPATIAL ACCESS TO SECOND TRIMESTER ABORTION

Objectives

We aimed to assess the relationship between social vulnerability and driving distances from each US county to the closest second trimester abortion clinic as of October 2023.

Methods

Using AbortionFinder.org, we calculated drive time from the centroid of each US county to the closest second trimester abortion facility. Data was joined to the Social Vulnerability Index (SVI) by county FIPS code. Counties were stratified into three SVI tertiles. We compared the median driving distance for states where second trimester abortions were legal vs not-legal. We used logistic regression models to determine the SVI predictors (lowest tertile vs highest tertile) of living in a county with a >2-hour driving distance of a second trimester abortion facility (adjusted for state legality of second trimester abortions).

Results

We assessed 3,143 US counties; 67.1% of counties were within a two-hour drive of a second trimester abortion facility. The median travel time for counties in states with legal second trimester abortion was 1.6 (range:0.1–7.3) vs 4.2 (range:0.9–12.0) hours p<0.001. In logistic regression, counties with the lowest socioeconomic SVI score had increased odds of a >2-hour drive (adjusted OR (aOR) 1.63;95%CI:1.28–2.17) and counties with the lowest racial/ethnic SVI score had increased odds of a >2-hour drive (aOR 1.56;95%CI:1.18–2.04).

Conclusions

Abortion bans disproportionately affect not only those living in restrictive states but also those who are more socially vulnerable. Current legislative and judicial efforts further threaten access to first trimester abortions including medication abortion nationwide. The necessity for second trimester abortions and inequity in access may increase.