State differences in abortion access: A new tool to understand access to care and capacity for change

Background: The well-known statistic that 87% of counties lack an abortion provider certainly illustrates the lack of access to a service that one in three women will need during her lifetime, however there are other methods to understand abortion access. This paper presents the results of a study that conceptualized access to abortion including both access to care and resources to improve services.

Study Design: The study compiled data from existing sources such as the US Census, the Natality Dataset, BRFSS, the Guttmacher Institute, and others. We gathered data in four general areas: demographics, health, laws and policies, and advocacy organizations' activities. We calculated a summated scale based on state rankings of these indicators to create an “access score” and an “opportunity score” for all 50 states.

Results: There are considerable disparities in abortion access and current capacity to improve that access between states. One measure of access, such as the percent of counties with an abortion provider, does not represent a complete understanding of the context in which abortion service delivery occurs. By conceptualizing both access to care and resources to improve services, our study provides a new way to think about abortion access.

Implications: Limited access to abortion has negative consequences on women's health and autonomy. Those working to improve access to abortion require better data to prioritize funding and plan programs. Our study contributes to this effort by providing a new method to understand access to care.