Richard Kimball1, Michael Wissner2. 1. Research, UNM College of Nursing, Albuquerque, New Mexico. 2. Geography and Environmental Systems, University of Maryland, Baltimore County, Baltimore, Maryland.
Abstract
OBJECTIVE: This study sought to explore the relationship(s) between U.S. states of selected social determinants of health (SDH) and three women's reproductive health outcomes including abortion, teen births, and infant mortality rates (IMR). DESIGN AND SAMPLE: The data from multiple population surveys were used to establish on a state-by-state basis, the interactions between selected SDH (religion, voting patterns, child poverty, and GINI) and their policy effects on three women's reproductive health outcomes (abortion, teen births, and IMRs) using publicly available national databases. MEASURES: Child poverty rates and the GINI coefficient were analyzed. Religiosity information was obtained from the Pew Forum's surveys. Voting results were collected from the 2008 congressional and presidential races and were used as proxy measures for conservative- versus liberal-leaning policies and policy makers. RESULTS: Using multiple regression analysis, higher IMRs were associated with higher religiosity scores. Lower abortion rates were associated with voting conservatively and higher income inequality. Higher teen birth rates were associated with higher child poverty rates and voting conservatively. CONCLUSIONS: This study shows that selected SDH may have substantial impacts on women's reproductive health outcomes at the state level. Significant inequalities exist between liberal and conservative states that affect women's health outcomes.
OBJECTIVE: This study sought to explore the relationship(s) between U.S. states of selected social determinants of health (SDH) and three women's reproductive health outcomes including abortion, teen births, and infant mortality rates (IMR). DESIGN AND SAMPLE: The data from multiple population surveys were used to establish on a state-by-state basis, the interactions between selected SDH (religion, voting patterns, child poverty, and GINI) and their policy effects on three women's reproductive health outcomes (abortion, teen births, and IMRs) using publicly available national databases. MEASURES: Child poverty rates and the GINI coefficient were analyzed. Religiosity information was obtained from the Pew Forum's surveys. Voting results were collected from the 2008 congressional and presidential races and were used as proxy measures for conservative- versus liberal-leaning policies and policy makers. RESULTS: Using multiple regression analysis, higher IMRs were associated with higher religiosity scores. Lower abortion rates were associated with voting conservatively and higher income inequality. Higher teen birth rates were associated with higher child poverty rates and voting conservatively. CONCLUSIONS: This study shows that selected SDH may have substantial impacts on women's reproductive health outcomes at the state level. Significant inequalities exist between liberal and conservative states that affect women's health outcomes.
Keywords:
community health nursing; geographic information systems (GIS); health disparities; health policy; population health outcomes; reproductive health; social determinants of health; social justice; socioeconomic factors; women's health
Authors: Danielle F Haley; Andrew Edmonds; Victor J Schoenbach; Catalina Ramirez; DeMarc A Hickson; Gina M Wingood; Hector Bolivar; Elizabeth Golub; Adaora A Adimora Journal: Ann Epidemiol Date: 2018-10-29 Impact factor: 3.797