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Financial Strain and Contraceptive Use Among Women in the United States: Differential Effects by Age

  • Sophie Lyons
    Affiliations
    Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California

    Department of Maternal, Child and Adolescent Health, School of Public Health, University of California, Berkeley, Berkeley, California
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  • Jennet Arcara
    Affiliations
    Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California
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  • Julianna Deardorff
    Affiliations
    Department of Maternal, Child and Adolescent Health, School of Public Health, University of California, Berkeley, Berkeley, California
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  • Anu Manchikanti Gomez
    Correspondence
    Correspondence to: Anu Manchikanti Gomez, PhD, Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA 94720-7400. Phone: +510-642-0722; fax: 510-643-6126.
    Affiliations
    Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, California
    Search for articles by this author
Published:February 02, 2019DOI:https://doi.org/10.1016/j.whi.2018.12.006

      Abstract

      Introduction

      Low-income and young women experience disproportionately high rates of unintended pregnancy. Traditional measures of socioeconomic status may not be appropriate indicators of financial status, particularly during emerging adulthood. This study investigates the relationship between financial strain and contraceptive use, focusing on the differential effects by age group.

      Methods

      Multinomial logistic regression analyses assessed the relationship between financial strain and contraceptive use in a national sample of U.S. women ages 18–39 years (N = 932). Models were adjusted for income, employment status, and other sociodemographic characteristics and tested the interaction of financial strain and age group.

      Results

      Women with high financial strain were less likely to use short-acting methods (compared with using no method) in the adjusted model; when the age and financial strain interaction was included, associations held only for women ages 18–24 and 25–29 years of age. Relative to contraceptive nonuse, women ages 18–24 years with high financial strain were less likely to use long-acting reversible (relative risk ratio [RRR], 0.10; 95% confidence interval [CI], 0.01–0.99) and short-acting hormonal (RRR, 0.03; 95% CI, 0.00–0.18) methods. Women ages 25–29 with high financial strain were less likely to use short-acting hormonal (RRR, 0.20; 95% CI, 0.05–0.87) and coital-specific (RRR, 0.11; 95% CI, 0.02–0.51) methods.

      Implications for Practice and/or Policy

      Young women may be vulnerable to the effect of high financial strain on contraceptive nonuse. Providers working with this group should consider incorporating financial strain into screening tools to identify patients who may need extra attention in contraceptive decision-making conversations. Antipoverty programs could also have a positive effect on effective contraceptive use.
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      Biography

      Sophie Lyons, MPH, MSW, began this work as a graduate student at the University of California, Berkeley. Her interests include how social determinants affect sexual and reproductive health among adolescents and women and how research is translated into programs and policy.

      Biography

      Jennet Arcara, MPH, MPP, is a PhD candidate, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Her research focuses on the roles of gender, autonomy, and power in reproductive health in U.S. and global contexts.

      Biography

      Julianna Deardorff, PhD, is Associate Professor, Maternal and Child Health program, University of California, Berkeley. Her research focuses on antecedents/consequences of girls' early puberty. She examines sexual behaviors/condom use during adolescence and related risk and protective factors, particularly among young Latinas.

      Biography

      Anu Manchikanti Gomez, PhD, is Assistant Professor and Director, SHARE Program, University of California, Berkeley. A health equity researcher, her scholarship advances the understanding/promotion of sexual/reproductive health equity, emphasizing social, relational, and structural determinants of health.