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Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use?
Corinne H Rocca1, Cynthia C Harper
1Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, CA, USA. roccac@obgyn.ucsf.edu
Perspectives on Sexual and Reproductive Health
|September 11, 2012
Summary
Racial and ethnic disparities in effective contraceptive use persist. While attitudes toward pregnancy and childbearing differ, they do not explain these gaps; lower contraceptive knowledge partially explains disparities for Latinas.
Area of Science:
- Reproductive Health
- Sociology of Health
- Health Disparities
Background:
- Racial and ethnic disparities in unintended pregnancy and contraceptive use remain significant in the U.S.
- The influence of attitudes towards contraception, pregnancy, and fertility on these disparities is understudied.
Purpose of the Study:
- To investigate the role of attitudes towards contraception, pregnancy, and fertility in contributing to racial and ethnic disparities in effective contraceptive method use among young, unmarried women.
- To assess whether specific beliefs mediate the relationship between race/ethnicity and contraceptive method choice.
Main Methods:
- Analysis of data from 602 unmarried women aged 18-29 at risk for unintended pregnancy from the 2009 National Survey of Reproductive and Contraceptive Knowledge.
- Mediation analysis using regression models to examine the contribution of attitudes to racial and ethnic disparities in effective method use.
Main Results:
- Black and Hispanic women held more negative views about government contraceptive promotion and were more fatalistic about pregnancy timing compared to white women.
- Attitudes did not mediate racial and ethnic disparities in effective contraceptive use; however, lower contraceptive knowledge partially explained disparities for Hispanic women.
- Skepticism about government contraceptive safety was linked to contraceptive use but did not vary by race or ethnicity.
Conclusions:
- Targeted provision of basic information on effective contraceptive methods may help reduce ethnic disparities in use.
- Further research is needed to explore other factors, such as health system characteristics and provider behavior, that may account for these persistent disparities.
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