Racial Inequities in Adolescent Contraceptive Care Delivery: A Reproductive Justice Issue.
J Pediatr Adolesc Gynecol
; 36(3): 298-303, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-36423806
ABSTRACT
STUDY OBJECTIVE:
The objective of this study was to examine racial/ethnic disparities in contraceptive delivery for adolescent patients within an adolescent medicine subspecialty clinical system before and during the COVID-19 pandemic. Secondarily, we aimed to assess the relationship between race and contraceptive delivery by telehealth.DESIGN:
Retrospective cohort study using electronic health record dataSETTING:
Three adolescent medicine subspecialty clinics in a large academic hospital system, including an urban location and 2 suburban locationsPARTICIPANTS:
Patients assigned female sex at birth prescribed hormonal contraception between January 1st, 2018, and May 31st, 2021. MAIN OUTCOMEMEASURES:
Method and type of contraceptive prescribed (short-acting, medium-acting, long-acting reversible contraception [LARC])RESULTS:
There were 2453 patients in the study; 47.5% were White, 36.0% were Black, and 8.1% identified as Hispanic. After controlling for insurance and age, Black patients, compared with non-Black patients, had twofold higher odds of receiving LARC compared with a short-acting method across the study period (aOR = 2.0; 95% CI, 1.52-2.62). We identified effect modification with significant interaction between Black race and the pandemic period, with evidence of a higher marginal probability of Black patients receiving LARCs during the pandemic. Additionally, during the pandemic, patients receiving new contraceptive prescriptions via telehealth were less likely to be Black (aOR = 0.63; 95% CI, 0.41-0.94) or publicly insured (aOR = 0.56; 95% CI, 0.38-0.81).CONCLUSION:
Our data show significantly higher prescribing of LARCs to Black adolescents by clinicians, which could suggest differences in physician contraceptive counseling with a bias toward preferentially counseling Black patients toward LARCs. Our data also show that Black and publicly insured patients had decreased utilization of contraceptive care by telehealth during the pandemic.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Anticoncepção
/
COVID-19
Tipo de estudo:
Observational_studies
Limite:
Adolescent
/
Female
/
Humans
/
Newborn
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article