Poverty and politics- their impact on women's reproductive health outcomes over time

This study looked at the social determinants of health (i.e., poverty rates, religiosity, and voting patterns) as critical factors in women’s reproductive health outcomes (i.e., IMR, teen pregnancy and abortion rates) over two presidential elections in 2004 and 2008. 

State level data of three women's reproductive health outcomes were used. The social determinant variables used were poverty rates, religiosity, and the voting results from the 2004 and 2008 presidential races, a proxy measures for conservative/liberal leaning policies/policy-makers.

States voting “red” had a significantly higher IMR than “blue” states (p<.01) in both 2004 and 2008.  Teen pregnancy rates were significantly greater in both years in “red” states than in “blue” states (p<.01).  Abortion rates were significantly lower in “red” states in both years than the “blue” states (p<.01).  Using regression analysis, higher IMR was associated with higher religiosity scores in both 2004 and 2008 (p<.01;r²=.50&.51).  Lower abortion rates were associated with voting conservatively in both years (p<.01;r²=.27&.34). Higher teen pregnancy was associated with higher poverty rates (p<.01) and voting conservatively (p<.01;r²=.74&.65).  In 2008, higher religiosity was also associated with higher teen pregnancy (p<.05). 

More attention needs to be paid to women’s health outcomes and effects of policies at the state level. There are significant inequalities between “blue” and “red” (i.e., liberal/conservative) states.  This gap is likely to widen with conservative states’ refusal to embrace Medicaid expansion and other provisions in the Affordable Care Act. Future research will look into specific policies that affect women's reproductive health outcomes.