Housing Stability and Access to General Healthcare and Reproductive Healthcare Among Women in Ohio

Abstract

Background The relationship between housing instability and reproductive healthcare is understudied. We examined the association between housing insecurity and access and utilization of general healthcare, contraceptive healthcare, and abortion care. Methods Using data from a population-representative survey of adult reproductive-age Ohio women (N = 2,529), we assessed housing insecurity (not paying rent/mortgage on time in the past year). We examined associations between housing insecurity and the following outcomes: (1) not being able to access general healthcare in the past year; (2) experiencing delays or difficulties in accessing contraceptive healthcare in the past year; and (3) ever having an abortion. We used unadjusted and adjusted logistic regression models. We selected confounders a priori and included age, socioeconomic status, and healthcare status. Results Overall, 10.6% of Ohio women of adult reproductive age experienced housing insecurity. Approximately 27.5% of respondents were not able to access general healthcare and 10.4% experienced delays or difficulties in accessing contraceptive care. Compared to housing-secure respondents, housing-insecure women were less able to access general healthcare (adjusted odds ratio [aOR]:2.16; 95% confidence interval [CI]:1.45–3.23) and more likely to experience delays or difficulties when accessing contraceptive care (aOR:1.74; 95% CI:1.00-3.04). Insecure housing was not statistically associated with ever having an abortion (aOR:1.76; 95% CI:0.93–3.34). Conclusions In this study, recent housing insecurity was associated with poorer access to general and contraceptive healthcare. Studies utilizing multidimensional measures of housing insecurity and other material insecurity measures are needed to further explore the relationship between material insecurity and access to general and contraceptive care. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03492-5.

Primary and reproductive healthcare access and use among reproductive aged women and female family planning patients in 3 states

“…Still, across the study populations, at least 20% reported not getting desired health care, and between 10% (Iowa and Wisconsin aged 18-44) and 19% (Arizona family planning clinic patients) had trouble or delays in obtaining their desired method of birth control in the past year, indicating that a significant proportion of women in all study populations are not fully getting their sexual and reproductive health care needs met. These levels of not being able to access desired health care and trouble in accessing contraception among reproductive-aged women are comparable to those documented among a similar population in Ohio during the same timeframe [15]. We found that cost is a primary barrier to healthcare services broadly and desired contraception specifically.…”

“…Presenting both domains allows for a richer description of the overall healthcare access context in which people are seeking SRH care. For example, a 2018–2019 survey among Ohio women revealed that more than a quarter of this group was unable to access general healthcare whereas about 10% had experienced delays or difficulties in accessing contraceptive care, suggesting that the ability to obtain contraceptive care is not an indicator of general healthcare access, and vice versa [ 15 ].…”