Strategic science is an important tool to incorporate into many academic fields when considering health disparities, and it is absolutely pivotal in abortion disparities. The existing body of literature demonstrates disparities in abortion among race/ethnicity and socioeconomic groups. Existing already are many obstacles to access of safe abortion care for all women, however these obstacles are exaggerated in women living in poverty and women of racial/ethnic minority backgrounds, affecting black non-Hispanic women most [1,2]. A few mechanisms for why these disparities exist include neighborhood characteristics that may put women at higher sexual risk, differences in family planning care (access, delivery and quality), differences in knowledge and perception of contraception and fertility and mistrust of medical providers or institutionalized racism [3].
Some of those in the anti-choice constituent support abortion restriction (and potentially even contraception restriction) legislation under the premise of abortion being a means of “genocide” of a particular race or class. This stems from the misappropriation of the important reproductive justice conversation about historical race and economic-based coercion as well as misinterpretation and misapplication of study findings evaluating abortion disparities; it incorrectly attributes those disparities to a targeted movement against particular groups. The potential exists that those that have heralded this “genocide” perspective don’t actually believe this to be true, however their communications with the public are framed as such and lead to a larger following of this perspective and subsequent political actions that affect women of racial/ethnic minorities and poverty.
This belief in disparities of abortion care reflecting targeted genocide is obviously misattributed, and policies and legislation that stem from this general conversation and impose abortion restrictions actually worsen these disparities in abortion care. Abortion advocacy groups have responded to this by creating ties between providers and policymakers to debunk myths about abortion care to help decrease the speed at which abortion restrictions are being imposed. However, more attention is warranted to the particular disparities that affect abortion care for marginalized groups in addition to the attention to overall abortion access for all women.
Community engagement could play a key factor in starting to address disparities in abortion. Neighborhood-based studies evaluating women’s experiences with family planning care and what structural and systematic obstacles they have faced in obtaining the care they needed. Developing a nuanced understanding of all of the factors that play into family planning outcomes these women experience may help delineate future interventions or arguments for policy changes that might bring change to these disparities. Community engagement may also provide the opportunity to develop trust of medical providers, which may help alleviate some of the disparities seen. An important piece to this last point will be to involve investigators and patient navigators of similar racial and ethnic backgrounds to interact with these women to help build and develop trust as well.
Additionally, communication of study and clinical findings evaluating abortion disparities more broadly with the general public (think public service announcements!) since they vote for the officials that are responsible for enacting these pieces of legislation would be important. Framing this information in the way it was intended to highlight the significant and unfair obstacles for marginalized women may help shape the perspective of the general public towards abortion provision in a positive light, and hopefully affect their voting patterns to deny legislators that are abortion restriction proponents access to policymaking.
Strategic involvement of those that are affected by this particular problem and the general public may help increase awareness of these disparities and move forward with addressing and hopefully decreasing their prevalence in abortion care.
References
- Finer, L., Frohwirth, L., Dauphinee, L., Singh, S., & Moore, A.Timing of steps and reasons for delay in obtaining abortion in the United States. Contraception 2006, 74, 334–344.doi:10.1016/j.contraception.2006.04.010
- Weitz, T., & Yanow, S. Implications of the federal abortion ban for women’s health in the United States. Reproductive Health Matters 2008, 16(31S), 99–107. Retrieved from www.rhmjournal.org/article/S0968-8080(08)31374-3/fulltext
- Dehlendorf C, Harris LH, Weitz TA. Disparities in abortion rates: a public health approach. Am J Public Health 2013, 103(10): 1772-9