Article

Health disparities and infertility: impacts of state-level insurance mandates

Williams College, Williamstown, New Jersey, United States
Fertility and sterility (Impact Factor: 4.3). 05/2006; 85(4):858-65. DOI: 10.1016/j.fertnstert.2005.11.038
Source: PubMed

ABSTRACT To determine whether important racial, ethnic, or socioeconomic status (SES) health disparities exist in infertility, impaired fecundity, or infertility treatment.
Four waves of the National Survey of Family Growth (NSFG) were pooled. Measures were compared across various race/ethnicity, education, and age groups.
Data for 31,047 women 15-44 years old from the NSFG were pooled.
Outcomes were compared by whether the women's states of residence had a mandate in place (at least 1 year before the interview) to compel insurers to cover or offer to cover infertility treatment.
Infertility status, impaired fecundity, ever having sought infertility treatment.
Infertility is more common for non-Hispanic black women, non-Hispanic other race women, and Hispanic women than for non-Hispanic white women, and both infertility and impaired fecundity are more common for high school dropouts and high school graduates with no college than for 4-year college graduates, and for older women compared with women 29 and younger. Older women, non-Hispanic white women, and women who are more educated (with at least some college) are more likely to have ever received treatment. No evidence has been found that the racial, ethnic, or education disparities are ameliorated by the health insurance mandates.
Racial, ethnic, and educational disparities exist in infertility status and treatment, and educational disparities in impaired fecundity. More study of the impact of infertility treatment mandates on these disparities is needed.

0 Bookmarks
 · 
93 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study examined whether public funding for in vitro fertilization (IVF) in Quebec, Canada was associated with differential access among Canadian-born infertility patients and those born outside of Canada. Anonymous demographic questionnaires were completed at 3 time points: 2 weeks before the implementation of public funding, 2 weeks after, and 8 months later. Almost half the patients were not born in Canada and of these, 35 % were recent immigrants to Canada. While patients born outside Canada were generally better educated than Canadian-born patients, they were more likely to be unemployed and have lower incomes. Following public funding, there was an overall increase in patients with lower incomes and lower levels of education. Canadian-born patients were more likely than immigrant patients to consult for secondary infertility. Patients born outside Canada tended to be older and nulliparous, suggesting that they may have delayed treatment seeking due to financial and other barriers. The results indicate that public funding reduces health disparities in access to IVF.
    Journal of Immigrant and Minority Health 05/2014; DOI:10.1007/s10903-014-0037-4 · 1.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper exploits variation in the mandated insurance coverage of assisted reproductive technology (ART) across US states and over time to examine the connection between increased access to ART and female marriage timing. Since ART increases the probability of pregnancy for older women of reproductive age, greater access to ART will make marriage delay less costly for younger single women of reproductive age. Linear probability models are estimated to investigate the effects of ART state insurance mandates on changes in marital status of women in different age groups using the 1977–2010 Current Population Survey. Results show that greater access to ART is associated with marital delay for white (but not for black) women: white women in states with an ART insurance mandate are significantly less likely to marry between the 20–24, 25–29, and 30–34 age ranges, but significantly more likely to marry between the 30–34 and 35–39 age ranges.
    Journal of Population Economics 04/2014; 27(2). DOI:10.1007/s00148-013-0487-3 · 0.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Childlessness is a major public health concern in the United States, particularly among educated adults. Among women who turned 45 in 2006, one fifth had no children. We examine the likelihood that a childless woman wants a baby sometime in the future and its determinants. From 2006 to 2010, 5,410 in-person interview surveys were conducted with childless women as part of the National Survey of Family Growth. Age-specific likelihoods of wanting a baby were compared with likelihoods of having a baby before age 45. Female respondents were 1) born after 1960, 2) age 15 to 44, 3) childless (never given birth to a live infant), and 4) not pregnant at time of interview. Most childless women at any age want a baby sometime in the future. By age 32, fewer than half the childless women who want a baby will have one. At age 39, the majority of childless women (73%) still want a baby someday, but only 7% will have one. By age 45, more than 1 in 10 women will be childless, but still want to have a baby. Although attitudes toward childlessness have become more positive over time, our findings suggest that the United States is experiencing a high prevalence of childless women who want a baby. Clinicians may consider counseling young women about age-related declines in fertility and the costs and success rates of assisted reproductive echnologies often required for women with advanced maternal age to better inform their career, family, and lifestyle decisions.
    Women s Health Issues 01/2014; 24(1):e21-e27. DOI:10.1016/j.whi.2013.09.005 · 1.61 Impact Factor

Preview

Download
0 Downloads
Available from