Recorded presentation

Kay A. Johnson, EdM, MPH, Department of Pediatrics, Dartmouth Medical School, C/O D Goodman, 7251 Strasenburgh Hall Dartmouth Med. School, Hanover, NH 03755, 802-482-3005, JohnsonGCI@aol.com, David Goodman, MD, MS, Center for Evaluative Clinical Sciences, Dartmouth Medical School, 7521 Strasenburgh Hall, Hanover, NH 03755, and Lorraine V. Klerman, DrPH, The Heller School for Social Policy and Management, Brandeis University, PO Box 9110, MS 035, 315 South Street, Waltham, MA 02454-9110.

Background: Although unintended and teen births remain persistent problems, the relation between family planning facility (FPF) availability and unintended or teen birth is not known. Objective: To measure the geographic availability of FPF and association with unintended/teen births. Study population: FPFs and women in AL, OK, and WA, 1998-2000. Data sources: include multiple FPF clinic lists, Pregnancy Risk Assessment Monitoring System, census, and natality files. Analytic methods: We calculated road-based travel times from population centroid of population ZIP Codes to nearest FPF street address, and used this measure in multivariable models of retrospective cohorts. Results: Most women (age 15-44 years) had short travel times to the nearest FPF. The percent of women residing greater than 30 minutes from FPF was 7.5% for AL, 2.5% for OK, and 8.7% for WA. The relationship between FPF proximity and the risk of unintended or teen birth was weak. For unintended births, adjusted ORs were < 5 min 1.0 (referent group), 5-15 minutes 0.99 (95% CI 0.88,1.12), >15-30 min 1.02 (0.88,1.19), >30-45 min 1.04 (0.68,1.59), >45 min 1.12 (0.25,4.95). For teen births, adjusted ORs were < 5 min 1.0 (referent group), 5-15 minutes 0.93 (95% CI 0.88,0.98), >15-30 min 0.86 (0.81,0.92), >30-45 min 0.69 (0.59,0.83), >45 min 1.05 (0.76,1.45). Conclusion: Greater proximity to FPF is not associated with lower rates of unintended or teen births. We are now studying the association of FPF structural and cultural characteristics with these reproductive outcomes.

Learning Objectives:

• At the end of this presentation, participants will be able to recognize the spectrum of family planning services geographic availability and its relation to reproductive outcomes.

Keywords: Family Planning, Access to Health Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation