Life course impacts of reduced access to contraception

NIH RePORTER · NIH · R01 · $681,884 · view on reporter.nih.gov ↗

Abstract

PROJECT SUMMARY Subsidies for contraception and even the right to use contraception are often justified on the basis of their benefits to women’s socioeconomic lives. While the benefits of expanding contraceptive access have been documented, reductions in access are now under consideration. Because reductions in access operate differently than expansions, they will not simply reverse the effects of expansions. Therefore, it is critical to understand how such reductions impact women’s social and economic outcomes. This project uses newly-developed data and one of the earliest and largest reductions in access to contraception to generate the first estimates of reduced contraceptive access in the US. The project will estimate the causal impact of reduced access to contraception using a massive policy experiment in Texas. In 2011, Texas decreased its grant-based contraceptive funding program by 2/3 and deprioritized dedicated family planning providers. These actions caused clinic closures, reduced access to the most effective methods, and were associated with increases in teen fertility. In partnership with the U.S. Census Bureau, the project will (Aim 1A) expand an individual-level longitudinal dataset, Reproduction in People’s Lives (RIPL), recording women’s fertility and human capital formation for nearly all reproductive-age U.S. women 2000-2026. RIPL links restricted individual-level microdata for the entire United States from the Census Numident, Master Address File–Auxiliary Reference File, three decennial Censuses, individual IRS tax filings, the Census Household Composition Key, and the 2005-2026 American Community Survey. The project will also (Aim 1B) integrate original survey-based and administrative clinic- level data on the spatial intensity of Texas reductions in contraceptive access into RIPL. And importantly, the project will (Aim 1C) yield a modular version of RIPL, so researchers on Census Bureau-approved projects can use our documented code to construct components of RIPL for replication, extension, and their own use. Changes in life course outcomes as Texans experienced reductions in access contraception will be compared to changes in comparison states using a difference-in-differences approach. In this way the project will (Aim 2) assess the impact of reductions in access to contraception on women’s fertility over their life course. Similarly, the project will (Aim 3) assess the impact of reductions in access to contraception on women’s economic outcomes and human capital accumulation. For each outcome, whether impacts vary by age at exposure, family of origin socioeconomic status, and race/ethnicity, as well as whether fertility mediates the impact of reduced access (Aim 4) on women’s socioeconomic lives will be assessed. Project findings will inform ongoing debates over the causal effects of access to contraception and fertility timing on socioeconomic outcomes. The data and methods developed may also be used by researchers on...

Key facts

NIH application ID
10973000
Project number
1R01HD116105-01
Recipient
UNIVERSITY OF COLORADO
Principal Investigator
Amanda Jean Stevenson
Activity code
R01
Funding institute
NIH
Fiscal year
2024
Award amount
$681,884
Award type
1
Project period
2024-09-16 → 2029-06-30