Understanding predictors of reproductive healthcare utilization for special populations of U.S. women: A special case for racial minorities and social conservatives

Barriers to healthcare access and evidence of lower quality of healthcare have been well documented for blacks and other vulnerable groups. However, the predictors of reproductive health care access and utilization in particular have not been studied extensively for minority women. Data are from a nationally representative sample of adult women (ages 18-45) who participated in the 2002 National Survey of Family Growth (n=7643). Using multivariate logistic regression, data were analyzed to assess the impact of health insurance status, race/ethnicity, and social attitudes about marriage, childrearing, and gender roles on the likelihood of having a yearly pelvic exam and utilizing STD testing and counseling services. After adjustment for covariates, Latina and black women were less likely to have had pelvic exams than white women (OR=0.79, 0.84, respectively). Uninsured women were significantly less likely to have a pelvic exam (OR=0.46) compared to privately insured women. Women who expressed conservative beliefs about the importance of marriage were less likely to have had a yearly pelvic exam than their more liberal counterparts (OR=0.88). Privately insured women were less likely to use STD counseling and testing services than women with public insurance (OR=0.73). Women with conservative beliefs about unmarried mothers and gay adoption were more likely to use STD testing and counseling services than their more liberal counterparts (OR=1.22, 1.25, respectively). Identifying potential barriers and facilitators of reproductive healthcare access has important implications for reducing disparities in reproductive health outcomes. Policies should include educating the privately insured about the confidentiality of medical services.