Disparities in access to fertility care: who’s in and who’s out

Epidemiology

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VOLUME 2, ISSUE 1, P109-117, MARCH 01, 2021

Authors:

Isabel Galic, B.A., Olivia Negris, M.A., Christopher Warren, Ph.D., Dannielle Brown, M.H.S., Alexandria Bozen, B.A., Tarun Jain, M.D. 

Abstract:

Objective

To study the racial and socioeconomic characteristics of women seeking fertility care in a state with mandated insurance coverage for fertility testing and treatment.


Design

Cross-sectional, self-administered survey.


Setting

Academic fertility center in Illinois.


Patient(s)

Of 5,000 consecutive fertility care patients, 1,460 completed the survey and were included in the study sample.


Intervention(s)

None.


Main Outcome Measure(s)

Details about demographic characteristics and health care access on the basis of patient race/ethnicity and socioeconomic status.


Result(s)

The mean age of participants was 36.1 years; 75.5% were White, 10.2% Asian, 7.3% Black, 5.7% Latinx, and 1.3% Other. Most women had a bachelor’s (35.5%) or master’s degree (40.5%) and an annual household income of >$100,000 (81.5%). Black and Hispanic women traveled twice as far (median 10 miles) as White and Asian women (median 5 miles for both) for treatment. Black women (14.7%) were more likely to report that their race was a barrier to getting fertility treatment compared with White (0.0%), Hispanic (5.1%), and Asian (5.4%) women. Black and Hispanic women were approximately twice as likely to report income level (26.5% and 20.3%, respectively) and weight (7.8% and 8.9%, respectively) as barriers compared with White and Asian respondents.


Conclusion(s)

Significant racial and socioeconomic disparities exist among fertility patients accessing care. Beyond providing all Americans with health insurance that covers fertility treatment, further research in the general population is needed to understand the complex social, cultural, racial, and economic factors that prohibit many individuals from accessing needed fertility care.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.