Affordable but Inaccessible? Contraception Deserts in the US States

Rebecca J. Kreitzer, Candis Watts Smith, Kellen A. Kane, Tracee M. Saunders

Research output: Contribution to journalArticlepeer-review


CONTEXT: This article focuses on whether, and the extent to which, the resources made available by Title X-the only federal policy aimed specifically at reproductive health care-are equitably accessible. Here, equitable means that barriers to accessing services are lowest for those people who need them most. METHODS: The authors use geographic information systems (GIS) and statistical/spatial analysis (specifically the integrated two-step floating catchment area [I2SFCA] method) to study the spatial and nonspatial accessibility of Title X clinics in 2018. FINDINGS: The authors find that contraception deserts vary across the states, with between 17% and 53% of the state population living in a desert. Furthermore, they find that low-income people and people of color are more likely to live in certain types of contraception deserts. CONCLUSIONS: The analyses reveal not only a wide range of sizes and shapes of contraception deserts across the US states but also a range of severity of inequity.

Original languageEnglish (US)
Pages (from-to)277-304
Number of pages28
JournalJournal of health politics, policy and law
Issue number2
StatePublished - Apr 1 2021

All Science Journal Classification (ASJC) codes

  • Health Policy

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