Medical research.com Interview with:
Rada K. Dagher, Ph.D.
University of Maryland School of Public Health
Department of Health Services Administration
College Park, MD 20742
MedicalResearch: What is the background for this study?
Dr. Dagher: In the United States, 51% of all pregnancies are unintended, and these happen disproportionately among racial and ethnic minorities. For example, in 2008, rates of unintended pregnancies were 69% among African American women, 56% among Hispanic women, and 40% among White women. Our study utilized 2006-2010 data from a nationally representative dataset, the National Survey of Family Growth, to investigate the reasons behind these racial/ethnic disparities.
MedicalResearch: What are the main findings of this study?
Dr. Dagher: The main findings of this study are as follows. Age and marital status differences explained both racial and ethnic disparities, where being single and younger than 20 years old at the time of conception contributed to the differences in unintended pregnancy between African American and White women, and between Hispanic and White women. However, there were also unique factors explaining the differences in unintended pregnancy between African Americans and Whites (respondent’s mother’s age at first birth, income, and insurance status) and the differences between Hispanics and Whites (U.S. born status and educational level). These findings provide support for culturally-tailored public health interventions that target at-risk groups of women such as younger, unmarried, lower income, lower educated, non-U.S. born women and those with public insurance, in order to reduce racial/ethnic disparities in unintended pregnancy.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Dagher: Our findings suggest that interventions to reduce racial and ethnic differences in unintended pregnancy should take into account multiple factors at multiple levels of influence. For example, at the policy level, the Affordable Care Act has mandated that health plans cover women’s preventative health care, including contraceptives, without cost sharing. Thus, primary care providers could educate their patients about these new policy provisions and encourage them to take advantage of them, especially patients at higher risk of unintended pregnancy such as women who are younger than 20, unmarried, non-U.S. born, have lower income, and those with public insurance.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Dagher: Our study only included data between 2006 and 2010. Thus, it would be interesting to explore using more recent data whether the Affordable Care Act’s (ACA) removal of cost sharing resulted in decreases in unintended pregnancy and related racial and ethnic disparities. Moreover, future research should consider examining the impact of the ACA on unintended pregnancy in states that have expanded Medicaid and have implemented state exchanges compared with states that have not. The expectation is that Medicaid expansion under the ACA may relieve some of the financial burden for lower–income women in states that expanded Medicaid.
Rada K. Dagher, Ph.D. (2015). Racial and Ethnic Differences Persist in Unintended Pregnancies