Racial and socioeconomic disparities in use of long-lasting contraception

Data from the National Survey of Family Growth suggest that poor women and women of color are more likely than privileged women to use long-lasting contraception such as sterilization, intrauterine devices (IUD), and Depo Provera. This disparity is noteworthy because long-lasting methods can and have been used coercively. To analyze this disparity, I constructed multivariate binary logistic regression models for female sterilization, IUD, and Depo Provera using the most recent National Survey of Family Growth available (Cycle 6, conducted by the National Center for Health Statistics (NCHS) in 2002). I examined the effect of both personal factors, including age, parity, and number of marriages, and social factors, including education and health coverage. Personal factors were strong predictors but could not explain racial and economic disparities that exist among contraceptive users. This analysis found that education and health coverage were also important variables. Even controlling for personal factors, women with less education were more likely to be sterilized or use Depo Provera than women with a bachelor's degree or more. Women covered by Medicaid or public, government, or military coverage were more likely to use Depo Provera than women with private insurance. Women covered by Medicaid were also more likely to be sterilized since 2000. And uninsured women were more likely to use an IUD than women with private health insurance. However, none of the independent variables completely erased the effect of race and income, suggesting further research is necessary to understand the disparity in use of long-lasting contraceptives.