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. 2019 Nov 4;7(4):E646-E653.
doi: 10.9778/cmajo.20190087. Print 2019 Oct-Dec.

Household income and contraceptive methods among female youth: a cross-sectional study using the Canadian Community Health Survey (2009-2010 and 2013-2014)

Elizabeth Nethery  1 , Laura Schummers  2 , K Suzanne Maginley  2 , Sheila Dunn  2 , Wendy V Norman  2
Affiliations

Household income and contraceptive methods among female youth: a cross-sectional study using the Canadian Community Health Survey (2009-2010 and 2013-2014)

Elizabeth Nethery et al. CMAJ Open. .

Abstract

Background: Low socioeconomic status is one of many barriers that may limit access to family planning services. We aimed to examine the relation between household income and contraceptive methods among female youth in Canada.

Methods: Our study population included sexually active females aged 15-24 who were trying to avoid pregnancy. We used cross-sectional data from the 2009-2010 and 2013-2014 cycles of the Canadian Community Health Survey to compare household income and other sociodemographic covariates for those using oral contraceptives, injectable contraceptives, condoms or a dual method (condoms plus oral or injectable contraceptives).

Results: Of female youth at risk for unintended pregnancy, 59.2% reported using oral contraceptives, 29.0% used dual methods, 16.8% used condoms only, 2.5% used injectable contraceptives and 13.6% did not use contraception. In multiple regression models, lower annual household income (< $80 000) was associated with decreased use of oral contraceptives (relative risk [RR] 0.85, 95% confidence interval [CI] 0.80-0.91) and dual methods (RR 0.81, 95% CI 0.71-0.91), increased use of condoms (RR 1.36, 95% CI 1.11-1.67) and injectable contraceptives (RR 1.69, 95% CI 0.98-2.92), and a greater risk of contraceptive nonuse (RR 1.19, 95% CI 0.94-1.50).

Interpretation: We found that lower household income was associated with decreased use of oral contraceptives and increased reliance on injectable contraceptives and condoms only. Young, low-income females may face barriers to accessing the full range of contraceptive methods available in Canada. Easier access to affordable contraception may decrease the number of female youth at risk for unintended pregnancy due to financial barriers.

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Conflict of interest statement

Competing interests: Wendy Norman reports grants from the Canadian Institutes of Health Research, Public Health Agency of Canada, and the Michael Smith Foundation for Health Research, and infrastructure support from the Women’s Health Research Institute, BC Women’s Hospital and Health Centre, Provincial Health Services Authority during the conduct of the study. She is a member of the Board of Directors of the Society of Family Planning. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Flow diagram showing selection of sample for analysis. Note: CCHS = Canadian Community Health Survey. *Numbers total more than 420 because some records were missing more than 1 value.
See this image and copyright information in PMC

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