USING THE INDEX OF CONCENTRATION AT THE EXTREMES TO MEASURE THE ASSOCIATION BETWEEN SPATIAL POLARIZATION AND DISTANCE TRAVELED FOR CARE IN A COLORADO CLINIC

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110561

E Dindinger, A Zhang, RH Cohen, J Sheeder

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引用次数: 0

Abstract

Objectives

We aimed to assess changes in geographical segregation and distance traveled for abortion, after Dobbs v Jackson Women’s Health Organization allowed states to implement greater abortion care restrictions, using the Index of Concentration at the Extremes (ICE), which quantifies extremes of disadvantage and privilege.

Methods

Data included all individuals obtaining an abortion at a university-affiliated clinic in Denver, CO between July 2021 and June 2023. We created two time periods: before (July 2021–June 2022) and after Dobbs (July 2022–June 2023). We compared ICE quintile distributions for individuals traveling >100 and >300 miles (vs. <100 and <300 miles, respectively) before and after Dobbs using chi-squared tests. We used logistic regression to determine the independent predictors of traveling >100 miles and >300 miles for abortion care adjusting for time period.

Results

We assessed 2,709 total abortions: 1,391 before and 1,318 after Dobbs. The proportion of individuals traveling >100 miles for abortion care increased from 22.57% to 36.72% (p<0.001), and those traveling >300 miles increased from 16.82% to 33.69% (p<0.001). In logistic regression, individuals in the most disadvantaged ICE quintile had 8.58 (adjusted OR (aOR); 95% CI [6.14 - 11.98]) times adjusted odds of traveling >100 miles and 9.04 (aOR; 95% CI [6.33 - 12.90]) times adjusted odds of traveling >300 miles for abortion care versus those in the least-disadvantaged ICE quintile and the odds of traveling >300 miles increased by 2.52 (aOR; 95% CI [2.08 - 3.04]) post Dobbs.

Conclusions

Abortion bans add to undue burden by increasing distance traveled for in-person care. These bans disproportionately impact communities already facing socioeconomic structural discrimination.

查看原文本刊更多论文

利用极端集中指数衡量科罗拉多州一家诊所的空间极化与就医距离之间的关系

目标我们旨在评估在多布斯诉杰克逊妇女健康组织案允许各州实施更多堕胎护理限制后，地理隔离和堕胎距离的变化情况，我们使用了极端集中指数（ICE），该指数量化了不利条件和特权的极端情况。我们创建了两个时间段：多布斯之前（2021 年 7 月至 2022 年 6 月）和多布斯之后（2022 年 7 月至 2023 年 6 月）。我们使用卡方检验比较了在多布斯之前和之后旅行>100英里和>300英里（分别为<100英里和<300英里）的个人的ICE五分位数分布。我们使用逻辑回归法来确定旅行 >100 英里和 >300 英里接受人工流产护理的独立预测因素，并对时间段进行调整：在多布斯之前有 1391 例，在多布斯之后有 1318 例。旅行>100英里接受人工流产护理的人数比例从22.57%增至36.72%（p<0.001），旅行>300英里接受人工流产护理的人数比例从16.82%增至33.69%（p<0.001）。在逻辑回归中，处境最不利的 ICE 五分之一人口旅行>100 英里的调整几率为 8.58（调整 OR（aOR）；95% CI [6.14 - 11.98]）倍，旅行>300 英里的调整几率为 9.04（aOR；95% CI [6.33 - 12.90]）倍。结论人工流产禁令增加了亲自护理的距离，从而增加了不必要的负担。这些禁令对已经面临社会经济结构性歧视的社区造成了不成比例的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.