Political, policy and practice implications of racial inequality in the use of and access to assisted reproductive technologies (ART)

Health disparities research in reproductive health often focuses on family planning, but the issue of infertility is often overlooked. Racial inequality in reproductive services has existed long before the advent of ART, and may be perpetuated by the increasing use and access of ART by some groups and not by others. Infertility is a significant public health problem impacting more than 6 million women in the United States, and disproportionately more women of racial and ethnic minorities. Despite the higher rates of infertility among non-Caucasian women, Caucasian women utilize assisted reproductive technology services at significantly higher rates than any other racial or ethnic group. Because ART provides an individual solution to what might be perceived as a public health problem, however, this issue has received little attention among policy makers and clinicians.

This paper will discuss a range of factors impacting access to infertility treatment services for all women, and the barriers that exist for some racial and ethnic groups (including insurance coverage, geographic location of fertility centers, educational level, and cultural acceptance). This paper will also examine whether disparities among fertility patients result from lack of information among patients as well as health care providers, socioeconomic status, disparate social policies, cultural factors and/or biological factors. Identifying and gaining a clearer understanding of the basis for racial inequality in fertility treatment is one way to increase family building options for all women and enhance overall reproductive health.