Hum. Reprod. Advance Access published online on September 20, 2009
Human Reproduction, doi:10.1093/humrep/dep333
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Trends and determinants of reproductive health service use among young women in the USA
1 Department of Epidemiology, Demography, and Social Sciences, Institut National de la Santé et de la Recherche Médical, Unit 822, Le Kremlin-Bicêtre, France 2 University of Massachusetts Medical School, Worcester, MA, USA 3 Office of Population Research, Princeton University, Wallace Hall, Princeton, NJ, USA 4 The Hull York Medical School, Cottingham Road, Hull, UK 5 Faculté de Médecine, University Paris-Sud, Le Kremlin-Bicêtre, France 6 INED, National Institute for Demographic Studies, Paris, France
7 Correspondence address. INSERM U822, 82 rue de general Leclerc, 94276 Le Kremlin Bicêtre, France. Tel: +33-1-45212367; E-mail: caroline.moreau{at}inserm.fr
BACKGROUND: This study explores the current patterns of reproductive health service use among young women in the USA and the changing influence of socio-demographic factors on the types of services used over time.
METHODS: The study population, drawn from the two last cycles of the National Survey of Family Growth, consists of women aged 15–24 (n = 2543 in 1995, n = 2157 in 2002). We examined trends in use of ‘contraceptive services’ and ‘other reproductive health services for preventive care’ and tested for changes in the patterns of use of these services over time. Logistic regression models were used to further clarify the factors associated with the use of the two types of services in 2002.
RESULTS: Results show no difference in the overall use of reproductive health services in the past year but did reveal changes in the type of service sought. Use of services for contraception increased by 10 percentage points (39.3% in 1995 to 49.7% in 2002, P < 0.001), although the use of other services remained stable (53.2% in 1995, 50.2% in 2002, P = 0.14). The patterns of use varied over time, exhibiting growing social disparities. In 2002, the use of contraceptive services depended on women's age, number of partners, personal and mother's level of education, and menstrual problems. The use of other reproductive health services for preventive care varied across women's socio-economic background.
CONCLUSION: This study demonstrates increasing social differentials in the use of reproductive health services for preventive care among young women in the USA between 1995 and 2002, a finding which calls for careful monitoring in the context of limited resources.
Key words: reproductive health services/health inequalities/family planning/USA/population-based study
This study was presented at the 2008 National Survey of Family Growth Research Conference, Hyattsville, MD, USA in 16–17 October 2008. Submitted on June 2, 2009; resubmitted on July 21, 2009; accepted on August 6, 2009.