Brief of Amici Curiae economists in support of respondents in Dobbs v. Jackson Women's Health Organization.

A pillar of Mississippi's argument in Dobbs v. Jackson Women's Health was that there is no evidence of "societal reliance" on abortion, meaning no reason to believe that access to abortion impacts the ability of women to participate in the economic and social life of the nation. Led by economist Caitlin Myers and attorney Anjali Srinivasan, more than 150 economists filed an amicus brief seeking to assist the Court in understanding that this assertion is erroneous. The economists describe developments in causal inference methodologies over the last three decades, and the ways in which these tools have been used to isolate the measure of the effects of abortion legalization in the 1970s and of abortion policies and access over the ensuing decades. The economists argue that there is a substantial body of well-developed and credible research that shows that abortion access has had and continues to have a significant effect on birth rates as well as broad downstream social and economic effects, including on women's educational attainment and job opportunities. What follows is a reprint of this brief.

Predicted changes in abortion access and incidence in a post-Roe world.

OBJECTIVE: To examine changes in travel distance and abortion incidence if Roe v. Wade were reversed or if abortion were further restricted. STUDY DESIGN: We used a national database of abortion facilities to calculate travel distances from the population centroids of United States counties to the nearest publicly-identifiable abortion facility. We then estimated these travel distances under two hypothetical post-Roe scenarios. In the first, abortion becomes illegal in eight states with preemptive "trigger bans." In the second, abortion becomes illegal in an additional 13 states classified as at high risk of outlawing abortions under most circumstances. Using previously-published estimates of the short-run causal effects of increases in travel distances on abortion rates in Texas, we estimate changes in abortion incidence under each scenario. RESULTS: If Roe were reversed and all high-risk states banned abortion, 39% of the national population of women aged 15-44 would experience increases in travel distances ranging from less than 1 mile to 791 miles. If these women respond similarly to travel distances as Texas women, county-level abortion rates would fall by amounts ranging from less than 1% to more than 40%. Aggregating across all affected regions, the average resident is expected to experience a 249 mile increase in travel distance, and the abortion rate is predicted to fall by 32.8% (95% confidence interval 25.9-39.6%) in the year following a Roe reversal. CONCLUSION: In the year following a reversal, increases in travel distances are predicted to prevent 93,546-143,561 women from accessing abortion care. IMPLICATIONS: A reversal or weakening of Roe is likely to increase spatial disparities in abortion access. This could translate to a reduction in abortion rates and an increase in unwanted births and self-managed abortions.

Can a social media campaign increase the use of long-acting reversible contraception? Evidence from a cluster randomized control trial using Facebook.

OBJECTIVE: To test whether an informational campaign carried out on social media increased use of long-acting reversible contraception (LARC). STUDY DESIGN: We implemented a stratified cluster randomized control trial to identify the effect of an informational campaign carried out using Facebook advertisements designed to increase knowledge of the efficacy, ease of use and safety of LARC. We randomized all zip codes in a three-state study area to either a control group or a treatment group. Female Facebook users age 18-34 living in treated clusters received advertisements developed by the researchers in partnership with Planned Parenthood of Northern New England (PPNNE), which sponsored the campaign. We assessed changes in the number and rate of LARC insertions at PPNNE health centers by patients' treatment status. RESULTS: Facebook showed 1.8 million advertisements to women residing in 536 randomly assigned treatment clusters. Women living in 545 control clusters did not receive advertisements. We observed 152,743 patient visits across PPNNE's 21 health centers over a 26-month period spanning the advertisement campaign. After treatment, the number of LARC insertions increased by 5.7% (95% CI 0.4%-11.3%, p=.04) among patients living in treated relative to control clusters. This result, however, is driven by patients at a single large health center that was experiencing an increase in patient volume prior to the intervention. If we drop this clinic from the sample, we find no evidence that the campaign had an effect on LARC insertions (0.8% reduction, 95% CI -7.6 to 6.5, p=.83). Moreover, if we control for patient volume, we also find no evidence that the campaign increased insertions per patient (0.5% relative increase in insertions, 95% CI -4.9% to 5.2%, p=.87). CONCLUSION: We conclude that the intervention did not have a detectable impact on LARC insertions in the 4 months after the ad campaign. IMPLICATIONS: This project demonstrates the importance of evaluating the impact of resources invested on advertising with the goal of promoting public health.

Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti.

Rigorous evaluations of food-assisted maternal and child health and nutrition programs are stymied by the ethics of randomizing recipients to a control treatment. Using nonexperimental matching methods, we evaluated the effect of 2 such programs on child linear growth in Haiti. The 2 well-implemented programs offered the same services (food assistance, behavior change communication, and preventive health services) to pregnant and lactating women and young children. They differed in that one (the preventive program) used blanket targeting of all children 6-23 mo, whereas the other (the recuperative program) targeted underweight (weight-for-age Z score < -2) children 6-59 mo, as traditionally done. We estimated program effects on height-for-age Z scores (HAZ) and stunting (HAZ < -2) by comparing outcomes of children in program areas with matched children from comparable populations in the Haiti Demographic and Health Survey. Children 12-41 mo in the preventive and recuperative program areas had lower prevalence of stunting than those in the matched control group [16 percentage points (pp) lower in preventive and 11 pp in recuperative]. Children in the 2 program areas also were more likely than those in the matched control group to be breast-fed up to 24 mo (25 pp higher in preventive, 22 in recuperative) and children 12 mo and older were more likely to have received the recommended full schedule of vaccinations (32 pp higher in preventive, 31 in recuperative). Both programs improved targeted behaviors and protected child growth in a time of deteriorating economic circumstances.