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Member Research and Reports

Maryland Study Explains Racial and Ethnic Disparities in Unintended Pregnancy

A new study from the University of Maryland School of Public Health examined why African American and Hispanic women have higher rates of unintended pregnancy than White women. Researchers found that there were unique factors explaining the differences in unintended pregnancy between African Americans and Whites and the differences between Hispanics and Whites. Maternal age and marital status differences also explained both racial and ethnic disparities. The study provides evidence in support of culturally-tailored public health interventions targeted to groups of women that may be younger, unmarried, lower-income, less-educated, non-U.S. born, or uninsured or publicly insured.

Rada Dagher_officialphoto
[Photo: Dr. Rada Dagher]

“Preventing unintended pregnancy should be a public health priority. In the United States, 51 percent of all pregnancies are unintended, and these happen disproportionately among racial and ethnic minorities,” says Dr. Dagher, assistant professor of health services administration at the University of Maryland School of Public Health and senior author on the study. This study is the first to use Fairlie decomposition analyses to investigate the reasons behind racial and ethnic disparities in unintended pregnancy. This statistical method helps with understanding the specific factors that explain the differences in rates of unintended pregnancy between African Americans and Whites, or Hispanics and Whites, and what percent of the difference each factor explains. It is published in the American Journal of Preventive Medicine. http://www.sciencedirect.com/science/article/pii/S0749379715006297

Dr. Dagher’s prior research has shown that women with unintended pregnancies take the shortest maternity leaves (http://bit.ly/1L44LzC), which may have a detrimental impact on their health (http://bit.ly/1PkYkeC) and the health of their babies. Other studies have shown that women with unintended pregnancies report increased levels of stress and depression, delayed prenatal care, increased likelihood of smoking and drinking during pregnancy, and are more likely to experience psychological and physical abuse. “The fact that African American and Hispanic women have even higher rates of unintended pregnancy than Whites (63 percent and 48 percent versus 42 percent, respectively) underscores the importance of tailoring multilevel interventions that address the underlying causes of the disparities,” Dr. Dagher said.

Being single and younger than 20 years old at the time of conception contributed to the differences in unintended pregnancy between African American and White women, and between Hispanic and White women. Earning below 100 percent Federal Poverty Level (FPL) compared to 200percent FPL or higher, having public insurance versus private insurance, and respondent’s mother being 25 years or younger contributed to the differences in unintended pregnancy between African American and White women. On the other hand, not being born in the U.S. and not having a Bachelor’s degree contributed to the differences between Hispanic and White women. The analytical model explained 51 percent of the difference in unintended pregnancy between African American and White women, and 73 percent of the difference between Hispanic and White women.

The study concludes that interventions to reduce unintended pregnancy should target at-risk groups of women such as younger, unmarried, lower income, lower educated, non-U.S. born women, and those with public insurance.

Racial/Ethnic Differences in Unintended Pregnancy: Evidence from a National Sample of U.S. Women was written by Drs. TheresaY. Kim, Rada K. Dagher, and Jie Chen and published in the American Journal of Preventive Medicine.

The article can be found at: http://www.sciencedirect.com/science/article/pii/S0749379715006297