Estimated Travel Time and Spatial Access to Abortion Facilities in the US Before and After the Dobbs v Jackson Women’s Health Decision

IMPORTANCE: Abortion facility closures resulted in a substantial decrease in access to abortion care in the US. OBJECTIVES: To investigate the changes in travel time to the nearest abortion facility after the Dobbs v Jackson Women’s Health Organization (referred to hereafter as Dobbs) US Supreme Cou...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2022-11, Vol.328 (20), p.2041-2047
Main Authors: Rader, Benjamin, Upadhyay, Ushma D, Sehgal, Neil K. R, Reis, Ben Y, Brownstein, John S, Hswen, Yulin
Format: Article
Language:English
Subjects:
Abortion
Abortion, Induced - statistics & numerical data
Abortion, Legal - legislation & jurisprudence
Age
Census
Court decisions
Cross-Sectional Studies
Decision analysis
Demographics
Female
Females
Humans
Online First
Original Investigation
Pregnancy
Public transportation
Reproductive health
Sensitivity
Spatial analysis
Travel
Travel time
Women's Health
Womens health
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Summary:IMPORTANCE: Abortion facility closures resulted in a substantial decrease in access to abortion care in the US. OBJECTIVES: To investigate the changes in travel time to the nearest abortion facility after the Dobbs v Jackson Women’s Health Organization (referred to hereafter as Dobbs) US Supreme Court decision. DESIGN, SETTING, AND PARTICIPANTS: Repeated cross-sectional spatial analysis of travel time from each census tract in the contiguous US (n = 82 993) to the nearest abortion facility (n = 1134) listed in the Advancing New Standards in Reproductive Health database. Census tract boundaries and demographics were defined by the 2020 American Community Survey. The spatial analysis compared access during the pre-Dobbs period (January-December 2021) with the post-Dobbs period (September 2022) for the estimated 63 718 431 females aged 15 to 44 years (reproductive age for this analysis) in the US (excluding Alaska and Hawaii). EXPOSURES: The Dobbs ruling and subsequent state laws restricting abortion procedures. The pre-Dobbs period measured abortion access to all facilities providing abortions in 2021. Post-Dobbs abortion access was measured by simulating the closure of all facilities in the 15 states with existing total or 6-week abortion bans in effect as of September 30, 2022. MAIN OUTCOMES AND MEASURES: Median and mean changes in surface travel time (eg, car, public transportation) to an abortion facility in the post-Dobbs period compared with the pre-Dobbs period and the total percentage of females of reproductive age living more than 60 minutes from abortion facilities during the pre- and post-Dobbs periods. RESULTS: Of 1134 abortion facilities in the US (at least 1 in every state; 8 in Alaska and Hawaii excluded), 749 were considered active during the pre-Dobbs period and 671 were considered active during a simulated post-Dobbs period. Median (IQR) and mean (SD) travel times to pre-Dobbs abortion facilities were estimated to be 10.9 (4.3-32.4) and 27.8 (42.0) minutes. Travel time to abortion facilities in the post-Dobbs period significantly increased (paired sample t test P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.2022.20424