TY - JOUR
T1 - Racial and ethnic differences in patterns of long-acting reversible contraceptive use in the United States, 2011–2015
AU - Kramer, Renee D.
AU - Higgins, Jenny A.
AU - Godecker, Amy L.
AU - Ehrenthal, Deborah B.
N1 - Funding Information:
We thank the editor and the two anonymous reviewers for their valuable feedback on this manuscript. Renee Kramer received travel support from the Master of Public Health Program, School of Medicine and Public Health, University of Wisconsin—Madison to present preliminary results of this study at the CityMatCH Leadership & MCH Epidemiology Conference in September 2016 in Philadelphia, PA. At the time of this study, Jenny Higgins was supported by grant K12 HD055894 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/5
Y1 - 2018/5
N2 - Objective: To investigate whether demographic, socioeconomic, and reproductive health characteristics affect long-acting reversible contraceptive (LARC) use differently by race-ethnicity. Results may inform the dialogue on racial pressure and bias in LARC promotion. Study design: Data derived from the 2011–2013 and 2013–2015 National Surveys of Family Growth (NSFG). Our study sample included 9321 women aged 15–44. Logistic regression analyses predicted current LARC use (yes vs. no). We tested interaction terms between race-ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) and covariates (for example, education, parity, poverty level) to explore whether their effects on LARC use vary by race-ethnicity. Results: In the race-interactions model, data did not show that low income and education predict LARC use more strongly among Black and Hispanic women than among White women. There was just one statistically significant race-interaction: experience of unintended pregnancy (p=.014). Among Whites and Hispanics, women who reported ever experiencing an unintended pregnancy had a higher predicted probability of LARC use than those who did not. On the other hand, among Black women, the experience of unintended pregnancy was not associated with a higher predicted probability of LARC use. Conclusions: With the exception of the experience of unintended pregnancy, findings from this large, nationally representative sample of women suggest similar patterns in LARC use by race-ethnicity. Implications: Results from this analysis of NSFG data do not provide evidence that observed differences in LARC use by race-ethnicity represent socioeconomic disparities, and may assuage some concerns about reproductive coercion among women of color. Nevertheless, it is absolutely critical that providers use patient-centered approaches for contraceptive counseling that promote women's autonomy in their reproductive health care decision-making.
AB - Objective: To investigate whether demographic, socioeconomic, and reproductive health characteristics affect long-acting reversible contraceptive (LARC) use differently by race-ethnicity. Results may inform the dialogue on racial pressure and bias in LARC promotion. Study design: Data derived from the 2011–2013 and 2013–2015 National Surveys of Family Growth (NSFG). Our study sample included 9321 women aged 15–44. Logistic regression analyses predicted current LARC use (yes vs. no). We tested interaction terms between race-ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) and covariates (for example, education, parity, poverty level) to explore whether their effects on LARC use vary by race-ethnicity. Results: In the race-interactions model, data did not show that low income and education predict LARC use more strongly among Black and Hispanic women than among White women. There was just one statistically significant race-interaction: experience of unintended pregnancy (p=.014). Among Whites and Hispanics, women who reported ever experiencing an unintended pregnancy had a higher predicted probability of LARC use than those who did not. On the other hand, among Black women, the experience of unintended pregnancy was not associated with a higher predicted probability of LARC use. Conclusions: With the exception of the experience of unintended pregnancy, findings from this large, nationally representative sample of women suggest similar patterns in LARC use by race-ethnicity. Implications: Results from this analysis of NSFG data do not provide evidence that observed differences in LARC use by race-ethnicity represent socioeconomic disparities, and may assuage some concerns about reproductive coercion among women of color. Nevertheless, it is absolutely critical that providers use patient-centered approaches for contraceptive counseling that promote women's autonomy in their reproductive health care decision-making.
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U2 - 10.1016/j.contraception.2018.01.006
DO - 10.1016/j.contraception.2018.01.006
M3 - Article
C2 - 29355492
AN - SCOPUS:85044530721
SN - 0010-7824
VL - 97
SP - 399
EP - 404
JO - Contraception
JF - Contraception
IS - 5
ER -