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Contraceptive Method Provision Patterns Among Rural and Urban Kentucky Medicaid Enrollees.

Dustin K Miracle1,2, Svetla Slavova2, Jeffery Talbert1,3

  • 1Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA.

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|May 4, 2026
PubMed
Summary
This summary is machine-generated.

Kentucky Medicaid data shows that while moderately effective contraceptives are common in rural areas, access to long-acting reversible contraceptives (LARCs) is significantly lower for those in non-urban counties.

Keywords:
contraceptioncontraception accesslong‐acting reversible contraceptionrural healthwomen's health

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Area of Science:

  • Public Health
  • Health Services Research
  • Reproductive Health

Background:

  • Contraceptive access is crucial for preventing unintended pregnancies.
  • Rural populations often face unique barriers to healthcare services, including reproductive health.
  • Understanding contraceptive provision patterns within state Medicaid programs is essential for identifying disparities.

Purpose of the Study:

  • To analyze contraceptive method distribution among Kentucky Medicaid enrollees.
  • To investigate potential rural-urban disparities in contraceptive provision.

Main Methods:

  • Analysis of Kentucky Medicaid claims data from 2019.
  • Identification of females at risk for unintended pregnancy using established criteria.
  • Multinomial logistic regression to compare contraceptive outcomes (less effective, moderately effective, LARC) based on rural-urban residence.

Main Results:

  • Over 239,000 individuals at risk for unintended pregnancy were analyzed.
  • Provision of moderately effective contraceptives was higher in rural-adjacent and rural-nonadjacent areas compared to urban.
  • Provision of long-acting reversible contraceptives (LARCs) was significantly lower in rural-nonadjacent areas compared to urban.

Conclusions:

  • While moderately effective contraceptive use is prevalent in rural Kentucky Medicaid enrollees, significant barriers to LARC access exist.
  • Disparities in LARC provision highlight the need for targeted interventions to improve access in rural populations.
  • Addressing these access barriers is critical for reducing unintended pregnancies and improving reproductive health outcomes.