Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov;2(11):e493-e500.
doi: 10.1016/S2468-2667(17)30158-5. Epub 2017 Oct 3.

Disparities and change over time in distance women would need to travel to have an abortion in the USA: a spatial analysis

Jonathan M Bearak  1 , Kristen Lagasse Burke  2 , Rachel K Jones  2
Affiliations

Disparities and change over time in distance women would need to travel to have an abortion in the USA: a spatial analysis

Jonathan M Bearak et al. Lancet Public Health. 2017 Nov.

Abstract

Background: Abortion can help women to control their fertility and is an important component of health care for women. Although women in the USA who live further from an abortion clinic are less likely to obtain an abortion than women who live closer to an abortion clinic, no national study has examined inequality in access to abortion and whether inequality has increased as the number of abortion clinics has declined.

Methods: For this analysis, we obtained data on abortion clinics for 2000, 2011, and 2014 from the Guttmacher Institute's Abortion Provider Census. Block groups and the percentage of women aged 15-44 years by census tract were obtained from the US Census Bureau. Distance to the nearest clinic was calculated for the population-weighted centroid of every block group. We calculated the median distance to an abortion clinic for women in each county and the median and 80th percentile distances for each state by weighting block groups by the number of women of reproductive age (15-44 years).

Findings: In 2014, women in the USA would have had to travel a median distance of 10·79 miles (17·36 km) to reach the nearest abortion clinic, although 20% of women would have had to travel 42·54 miles (68·46 km) or more. We found substantially greater variation within than between states because, even in mostly rural states, women and clinics were concentrated in urban areas. We identified spatial disparities in abortion access, which were broadly unchanged, at least as far back as 2000.

Interpretation: We showed substantial and persistent spatial disparities in access to abortion in the USA. These results contribute to an emerging literature documenting similar disparities in other high-income countries.

Funding: An anonymous grant to the Guttmacher Institute.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests

We declare no competing interests.

Figures

Figure 1
Figure 1. Median distance to the nearest abortion provider by state, 2014
Alaska and Hawaii are inset in the bottom-left corner.
Figure 2
Figure 2. Median distance to the nearest abortion provider by county, 2014
Alaska and Hawaii are inset in the bottom-left corner.
Figure 3
Figure 3. Change in median distance to the nearest abortion provider by county, 2011–14
Alaska and Hawaii are inset in the bottom-left corner.
See this image and copyright information in PMC

Comment in

References

    1. Committee on Health Care for Underserved Women. ACOG Committee opinion no 613: increasing access to abortion. Obstet Gynecol. 2014;124:1060–65. - PubMed
    1. American Public Health Association. Restricted access to abortion violates human rights, precludes reproductive justice, and demands public health intervention. [accessed Dec 13, 2016];Policy number 20152. 2015 https://www.apha.org/policies-and-advocacy/public-health-policy-statemen....
    1. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374:843–52. - PMC - PubMed
    1. Grossman D, White K, Hopkins K, Potter JE. Change in distance to nearest facility and abortion in Texas, 2012 to 2014. JAMA. 2017;317:437–39. - PMC - PubMed
    1. Shelton JD, Brann EA, Schulz KF. Abortion utilization: does travel distance matter? Fam Plann Perspect. 1976;8:260–62. - PubMed

Publication types