Sociodemographic disparities in preventive family planning service use among adult women in the u.s

Objective: To examine factors associated with adult women's use of preventive family planning services, 2006-2010. Methods: Data were drawn from The National Survey of Family Growth. Household interviews were conducted with 12,279 U.S. women ages 15-44 years between 2006-2010. We focused on women aged 25 and older who were at risk of unintended pregnancy during the previous year (n=4,768). Our primary outcome was preventive family planning service utilization (contraceptive or emergency contraceptive method provision, evaluation or counseling services). We used multivariable logistic regression to identify differentials in service use by women's sociodemographic characteristics. Results: Less than half (44%) of adult women at risk of unintended pregnancy in the previous year had used contraceptive services. In multivariable models controlling for sexual and reproductive characteristics, determinants of service use included age, race/ethnicity, insurance coverage and employment status. Older women ages 30-34 years (OR 0.5, 95%CI 0.4-0.6) and 35-40 years (OR 0.3, CI 0.2-0.4) and uninsured women (OR 0.7, CI 0.6-0.8) had a reduced odds of service use compared to younger and insured women. White (OR 1.4, CI 1.1-1.7) and employed (OR 1.3, CI 1.0-1.6) women had a greater odds of service use compared to Hispanic and unemployed women. In age-stratified models, insurance and employment status remained the strongest predictors of service use. Conclusion: Recent disparities in contraceptive service utilization in the U.S disproportionately impacted older and socially disadvantaged women. Future research can examine the impact of the Affordable Care Act on family planning service use and unintended pregnancy outcomes among these groups.