Wednesday, October 4, 2017

Lancet article on distance to abortion providers spawns some urbancentric headlines

The Lancet Public Health, the prestigious medical journal, published an article yesterday about the distances women in the U.S. have to travel for abortion care, and lots of mainstream media outlets picked up the story.  What initially struck me about several stories was the focus on this fact:  1 in 5 U.S. women must travel more than 43 miles to get to an abortion provider.  This is a factoid that would have the average rural woman thinking, "no big deal," because rural residents travel distances like that for everyday activities--like getting to work.  What burdens many rural women, you see, are much greater distances.

An opening line of the Guttmacher Institute's press release about the article does acknowledge some other key data points:
Nationally, half of all women of reproductive age lived within 11 miles of the nearest abortion clinic in 2014.  However, a substantial minority of women, particularly those in rural areas, lived significantly farther away.  (emphasis added)
The article was written by three Guttmacher Institute researchers, including lead author Jonathan Bearak.  The map accompanying the article shows a big swath running north to south through the middle of America as the most vast abortion desert.


NPR's coverage did a better job of highlighting what I would say is the more salient fact regarding rural women.  Their headline was "For Many Women, the Nearest Abortion Provider is Hundreds of Miles Away." Sarah McCammon's story features a woman in Sioux Falls, South Dakota who elected to drive four hours to Minneapolis for an abortion because the State of Minnesota does not impose a 72-hour waiting period like South Dakota does.

Here's another excerpt from Guttmacher's press release, which quotes Bearak:
Women and abortion clinics are both concentrated in urban areas, so it is not surprising that most women live relatively close to an abortion clinic.  However, distance may be a significant barrier to accessing abortion care for the substantial minority who live farther away, and especially for economically disadvantaged women, who make up the majority of abortion patients.
The title of The Lancet article is "Disparities and Change Over Time in Distance Needed to Travel to Access an Abortion in the U.S.:  A Spatial Analysis."  One of the "over time" findings is that between 2011 and 2014, distances to clinics remained the same in 34 states, while they increased in 7.  Needless to say, the states where the distances have increased include Wisconsin, Texas, and Alabama, all of which have passed so-called TRAP laws, Targeted Regulation of Abortion Providers, the constitutionality of which have been litigated in recent years.

CNN's coverage of the article featured a more appropriate headline that pleased me for its focus on the extreme distances facing some women.  The headline is "Some US women travel hundreds of miles for abortions, analysis finds."  That story included this additional information, the first line of which states what should be obvious:
"How far a woman has to travel for an abortion is a key measure of access," Bearak said. Other measures include restrictive laws and financial constraints.

To analyze how far women travel to terminate a pregnancy across the nation, the researchers began with data on the location of abortion providers and women. The information on women was based on census block groups, Bearak said: "That is the smallest publicly available geographic unit." Within states are counties, within counties are census tracts, and within tracts are block groups.
This analysis sounds very similar to what researchers did to quantify abortion availability in Texas following the different stages of implementation of House Bill 2, which was ultimately struck down by the U.S. Supreme Court in Whole Woman's Health v. Hellerstedt in 2016. 

My extensive writing about distance, travel, and abortion access is here, here, and here, along with many posts under the "abortion" label on the Legal Ruralism blog.

Cross-posted to Feminist Legal Theory.

2 comments:

dbk said...

As so many other aspects of social policy--which you frequently point to in other posts--calculations of distance to provider at the macro-level are skewed to urban and suburban populations.

One more in a long series of very insightful comments-posts.

I'd be interested to learn your response to this piece, published today on the WaPo
http://www.washingtonpost.com/sf/local/2017/10/06/her-disability-check-was-gone-and-now-the-only-option-left-was-also-one-of-the-worst/?hpid=hp_hp-top-table-main_economydisabled-702am%3Ahomepage%2Fstory&utm_term=.624df6454d27

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