Reducing health disparities by removing cost, access, and knowledge barriers

Area of Science:

• Public Health
• Reproductive Health
• Health Disparities

Background:

• Teen unintended pregnancy rates in the U.S. remain high, particularly among minority adolescents, despite national declines.
• Significant racial disparities persist in unintended pregnancy rates, disproportionately affecting Black teenagers.

Purpose of the Study:

• To analyze unintended pregnancy risk in Black and White teens (ages 15-19) after removing barriers related to access, cost, and knowledge.
• To determine if eliminating these barriers reduces racial disparities in teen pregnancy.

Main Methods:

• Secondary analysis of the Contraceptive CHOICE Project database (9256 participants, ages 14-45, 2007-2013).
• Examined unintended pregnancy rates and risks among sexually active teens (ages 15-19) from 2008-2013.
• Utilized absolute (rate difference) and relative (rate ratio) measures to assess Black-White disparities.

Main Results:

• National data showed persistent racial disparities, with Black teens having 2.5 times the unintended pregnancy rate of White teens (2011).
• Within the CHOICE Project, racial disparities in unintended pregnancy among teens decreased significantly over time.
• By 2012-2013, the rate difference was -1.5 and the rate ratio was 1.0, indicating near-equal rates between Black and White teens.

Conclusions:

• Removing barriers to reproductive healthcare access, cost, and knowledge substantially reduces Black-White disparities in unintended pregnancy rates among teens.
• When barriers are removed, unintended pregnancy rates become nearly equal between Black and White teenagers, contrasting with national trends.