Kentucky's abortion landscape, 2010 to 2019: an analysis of pre-Dobbs abortion disparities in a rural, restrictive state.

Background: Since 2010, many US states have passed laws restricting abortion providers' ability to provide care. Such legislation has no demonstrated health benefits and creates inequitable barriers for patients. Methods: To examine how Kentucky's abortion policies coincided with facility closures and abortion utilisation, we conducted a review of state abortion policies from 2010 to 2019 using newspapers and websites. We calculated abortion rates (abortions per 1000 women ages 15-44) by state of residence and provision for Kentucky, the South, and the US using data from the CDC and Kentucky Department of Health. We calculated percentages leaving and from out-of-state, and analysed abortions by race, pregnancy duration, and method. Findings: Of 17 policies passed between 2010 and 2019, ten were enacted, including 20-week and telemedicine bans. One of Kentucky's two abortion facilities closed in 2017. The pooled average abortion rate in Kentucky (4.1) and for Kentuckians (5.8) was lower than national averages (11.8 and 11.1). An average of 38% of Kentuckians left their state for care, compared to 7% nationally. In 2019, the abortion rate in Kentucky was 5.8 times higher for Black patients than White patients (compared to 4.8 times nationally). The majority (62%) of abortions in Kentucky took place at 7-13 weeks' gestation. Interpretation: Abortions in Kentucky were less frequent than in the South and US. The larger Black-White abortion rate gap reflects race- and class-based structural inequities in healthcare. Without federal protections, abortion access in Kentucky will continue waning. Funding: This study was supported by a philanthropic foundation that makes grants anonymously.

Abortion Access in Ohio's Changing Legislative Context, 2010-2018.

Objectives. To examine abortion utilization in Ohio from 2010 to 2018, a period when more than 15 abortion-related laws became effective.Methods. We evaluated changes in abortion rates and ratios examining gestation, geographic distribution, and abortion method in Ohio from 2010 to 2018. We used data from Ohio's Office of Vital Statistics, the Centers for Disease Control and Prevention's Abortion Surveillance Reports, the American Community Survey, and Ohio's Public Health Data Warehouse.Results. During 2010 through 2018, abortion rates declined similarly in Ohio, the Midwest, and the United States. In Ohio, the proportion of early first trimester abortions decreased; the proportion of abortions increased in nearly every later gestation category. Abortion ratios decreased sharply in most rural counties. When clinics closed, abortion ratios dropped in nearby counties.Conclusions. More Ohioans had abortions later in the first trimester, compared with national patterns, suggesting delays to care. Steeper decreases in abortion ratios in rural versus urban counties suggest geographic inequity in abortion access.Public Health Implications. Policies restricting abortion access in Ohio co-occur with delays to care and increasing geographic inequities. Restrictive policies do not improve reproductive health.

Stress Reduction Strategies Used by Midlife Black Women to Target Cardiovascular Risk.

BACKGROUND: Midlife black women are at a high risk for cardiovascular disease and experience higher morbidity and mortality rates. Chronic life stress contributes to the existent cardiovascular-related disparities for midlife black women. OBJECTIVES: The purpose of this qualitative study was to describe stress reduction strategies relevant to midlife black women, identify barriers, and generate ideas for the development of a stress reduction wellness intervention for midlife black women. METHODS: A community advisory board consisting of 11 midlife black women from the Midwest was established and charged with exploring life stress and stress-related issues for women like themselves. The community advisory board was led through a series of focus group discussions using open-ended questions focused on stress reduction strategies used by midlife black women, what kept them from incorporating stress reduction strategies into their daily routines, and what would be helpful in a stress reduction routine. Discussions were audiotaped, transcribed, coded, and analyzed using content analysis. RESULTS: Stress reduction strategies identified included exercise, faith and prayer, self-care, sisterhood, volunteerism, and mindfulness. Barriers to adopting stress reduction behaviors included time, finances, physical limitations, health status, health insurance, and guilt. Suggested modes of delivery for an intervention included informative lectures and coaching, demonstration, team sessions, social media, and continued access. CONCLUSIONS: Findings from this study were consistent with those from a preliminary study focused on midlife black women from the West Coast. Recommendations will inform development of a stress reduction wellness intervention for midlife black women.

Leveraging Community Engagement to Develop Culturally Tailored Stress Management Interventions in Midlife Black Women.

Chronic stress is a social health determinant associated with many persistent health conditions and health disparities for midlife Black women. Midlife Black women in the United States are exposed to multiple, competing stressors, increasing their risk for adverse health outcomes. The objective of the current study was to illicit information about the key life stressors experienced by midlife Black women. Focus groups were conducted using a convenience sample of midlife Black women (N = 11, age range = 41 to 54 years). Coding and thematic analysis identified four primary sources of stress: workplace, parenting, finances, and social media. Gendered racism and discrimination and life imbalance emerged as underlying stressors linked to the Strong Black Woman persona. This persona prioritizes resilience and self-reliance while suppressing self-care. The stressors identified will inform the development of an intervention and should be considered when providing care for midlife Black women. [Journal of Psychosocial Nursing and Mental Health Services, 57(3), 32-38.].

Mapping the Intersections of Violence on Black Women's Sexual Health within the Jim Crow Geographies of Cincinnati Neighborhoods.

Who will revere the Black woman? Who will keep our neighborhoods safe for Black innocent womanhood? Black womanhood is outraged and humiliated. Black womanhood cries for dignity and restitution and salvation. Black womanhood wants and needs protection, and keeping, and holding. Who will assuage her indignation? Who will keep her precious and pure? Who will glorify and proclaim her beautiful image? To whom will she cry rape? Abbey Lincoln, 1970.

Beauty and Body Image Concerns Among African American College Women.

The current study examined body image concerns among African American women. In recent years, there has been an attempt to include ethnic minority samples in body image studies (e.g., Grabe & Hyde, 2006; Hrabosky & Grilo, 2007; Lovejoy, 2001) but few specifically examine unique issues pertaining to beauty and body image for African American college age women. A total of 31 African American women participated in one of five focus groups on the campus of a large Southwestern University to examine beauty and body image. Data were analyzed using a thematic approach and several themes were identified. The majority of themes pertained to issues related to hair, skin tone, body type, and message sources. Themes included: sacrifice, ignorance/racial microaggressions, and validation and invalidation by others, thick/toned/curvy as optimal, hypersexualization, and being thin is for White women. Findings of the current study suggest a reconceptualization of body image for African American women where relevant characteristics such as hair and skin tone are given more priority over traditional body image concerns often associated with European American women.

Women, microcredit and family planning practices: a case study from rural Ghana.

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women's demographic background characteristics, membership status and length, and women's empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.