Variation in state unintended pregnancy rates in the United States.

CONTEXT: Newly available data show large differences in rates of unintended pregnancy across states. Because key policy and program decisions that could affect these rates are made by state governments, it is important to assess whether characteristics of the states are associated with this variation.
METHODS: Regression analysis was used to assess the relationship between the variation in state unintended pregnancy rates in 2006 and state-level aggregate measures of demographic composition, socioeconomic conditions, contraceptive use, and funding of and access to family planning services.
RESULTS: State unintended pregnancy rates were positively associated with the proportion of resident women who were black or Hispanic. However, these associations were almost entirely accounted for by differences in the age and marital status of women, the proportion without health insurance and the proportion receiving Medicaid. In addition, these last two measures were strongly associated with state unintended pregnancy rates after the other measures were controlled for: An increase in the proportion of women uninsured was associated with elevated unintended pregnancy rates, and an increase in the proportion receiving Medicaid coverage was associated with reduced rates.
CONCLUSIONS: State programs and policies should pay particular attention to increasing support for family planning services for minority groups. Findings also suggest that insurance coverage and receipt of Medicaid among women of reproductive age deserve further exploration as potentially important mechanisms for reducing state unintended pregnancy rates.