Racial Inequities in Adolescent Contraceptive Care Delivery: A Reproductive Justice Issue

Area of Science:

• Reproductive Health
• Health Disparities
• Adolescent Medicine

Background:

• Racial and ethnic disparities in contraceptive delivery persist.
• Understanding these disparities is crucial for equitable adolescent healthcare.
• The COVID-19 pandemic may have exacerbated existing inequalities.

Purpose of the Study:

• To investigate racial/ethnic disparities in contraceptive method delivery among adolescent patients.
• To compare contraceptive delivery before and during the COVID-19 pandemic.
• To assess the impact of race on telehealth contraceptive delivery.

Main Methods:

• Retrospective cohort study of 2453 adolescent patients prescribed hormonal contraception.
• Data extracted from electronic health records of three adolescent medicine clinics.
• Analysis focused on contraceptive method type (short-acting, medium-acting, long-acting reversible contraception [LARC]) and delivery via telehealth.

Main Results:

• Black adolescents had twofold higher odds of receiving LARC compared to short-acting methods (aOR=2.0).
• A higher probability of Black patients receiving LARC was observed during the pandemic.
• During the pandemic, Black patients and those with public insurance were less likely to use telehealth for new contraceptive prescriptions.

Conclusions:

• Clinician bias towards recommending LARC for Black adolescents may contribute to observed disparities.
• Black and publicly insured patients experienced reduced access to contraceptive care via telehealth during the pandemic.
• Findings highlight the need for equitable contraceptive counseling and accessible telehealth services for adolescents.