441 - Concerning Trends in Hormonal Birth Control Use among Teen Females between Politically Conservative versus Liberal States

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 441
Publication Number: 441.1

Aruna Chandran, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Ritika Purbey, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Ladonna Benning, Johns Hopkins University School of Public Health, Baltimore, MD, United States; Magdalena P.. Gareca, Temple University College of Public Health, Philadelphia, PA, United States; Emily A. Knapp, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States

Presenting Author(s)

Aruna Chandran, MD, MPH (she/her/hers)

Senior Scientist
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Background: Unintended teen pregnancies are associated with adverse health consequences. Strategies effective in preventing unintended pregnancy include comprehensive sexual education programs and access to hormonal contraception.

Beginning in 2017, federal rules restricting access to contraception were accompanied by for less-comprehensive “abstinence-only” sex education programs.

Objective:

Given the widening divide at the state level in access, funding, education, and sociopolitical context surrounding birth control, we explored how hormonal birth control use for the prevention of pregnancy in 2019 may have differed compared with prior years between liberal vs. conservative states.

Design/Methods:

State support for Donald J. Trump vs. Hillary R. Clinton in the 2016 US Presidential election was our exposure. The primary outcome was reported use of hormonal birth control among female students from the Youth Risk Behavior Surveillance System (YRBSS) in 2013-2019. A weighted adjusted linear regression model evaluated whether there was a change in the reported use of hormonal birth control in 2019 by election result status.

Results:

We analyzed data from 7,714 females from 39 states; of these, 2,425 reported having used hormonal birth control to prevent pregnancy. In 2019, the proportion of hormonal birth control use in Clinton-supporting states was 41.9% compared with 30.2% in Trump-supporting states (p=0.01; no difference between these states in 2013-2017). In 2019, hormonal birth control use decreased by 9.8% (95% CI: -0.187, -0.010) among females from Trump-supporting states (Figure 1).

Conclusion(s):

Our study highlights a dramatic shift in reported hormonal birth control use among teens in a short period of time between politically conservative vs. liberal states. This mirrored a change in the sociopolitical environment related to support for family planning. This suggests potential for a significant increase in unintended pregnancies among teens who live in politically conservative compared with liberal states. It is important for public health officials not to shy away from confronting the sociopolitical context in which health-related decisions are made, and protect our children’s health and health equity.