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Methodological considerations for investigating the impact of abortion restrictions on outcomes using aggregate panel
Alison Gemmill1, Alexander Franks2, Avi Feller3
1Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, United States.
None:
Dramatic changes in the US abortion policy landscape have led to growing interest in studying the health and social impacts of abortion bans. Many studies of population-level impacts necessarily rely on panel designs using aggregate state-level data to strengthen causal inference, yet such analyses risk pitfalls if they apply generic evaluation frameworks that overlook the complexity of the US abortion context and relevant outcomes. This commentary provides practical guidance for researchers engaged in panel studies of abortion policy, as well as for peer reviewers who may be less familiar with the methodological and substantive considerations in this area. Drawing from recent work, we highlight abortion-specific challenges that require attention, including time-varying confounding and violation of parallel trends, COVID-era disruptions, data suppression, spillover effects, and subgroup heterogeneity. We further recommend assessing sensitivity to including Texas, given its earlier implementation of abortion restrictions and potential outsized influence on results. Ultimately, we emphasize that rigorous evaluation of abortion policies requires thoughtful study design, context-specific considerations, and collaboration between methodologists and subject-matter experts.
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