1Center or American Progress | Young Women and Reproductive Health Care
Young Women and ReproductiveHealth Care
Reproductive Care Is the Primary Health Care Needfor Young Women
Jessica Arons, Lucy Panza, and Lindsay Rosenthal July 30, 2012
Introduction
Policymakers oen rea reproducive healh care dierenly rom oher orms o healhcare, bu ask any young woman, and she will ell you ha gynecological care is a unda-menal par o her healh care. Tis year’s debae in Washingon around conracepionhas a imes missed he mos imporan issue: When we alk abou young women’shealh care, mos o he ime we are alking abou heir reproducive healh care. Ye some conservaive, religiously aliaed universiies and nonprof organizaionsare rying o op ou o an Obama adminisraion regulaion ha requires healh planso cover conracepion wih no cos-sharing such as co-pays and deducibles. Because women now make up he majoriy o sudens enrolled in higher educaion,
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and because women comprise he majoriy o sa a nonprof insiuions,
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i is imporano look a he healh needs o hese women.Tis ac shee presens some imporan inormaion abou he healh care services hahese women need and use.
Reproductive and sexual health is a primary health care needfor young women
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For many young women, heir annual visi o heir obserician/gynecologis may beheir only consisen conac wih a docor, and i is oen heir primary ineracion wihhe healh care sysem.
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Young women use gynecological visis or a range o services,rom checking heir blood pressure o obaining a breas exam, rom receiving radiionalgynecological services such as screening or sexually ransmited inecions or birh con-rol prescripions o being screened or depression and menal healh disorders.
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2Center or American Progress | Young Women and Reproductive Health Care
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Reproducive healh care is undamenal o and inseparable rom women’s overallhealh and well-being. As such, i’s no surprising ha women ages 18 o 34 are moresaisfed wih heir care when heir regular provider is a reproducive healh specialis,primarily OB-GYN physicians.
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2,248,000 women in heir 20s needed prenaal care in 2009. By comparison, only 414,831 women under he age o 20 and 1,543,066 women older han 30 neededprenaal care ha year.
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Te Ceners or Disease Conrol and Prevenion repors ha even hough youngpeople ages 15 o 24 represen only 25 percen o he sexually experienced populaion,hey acquire nearly hal o all new sexually ransmited inecions.
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Compared wiholder aduls, sexually acive adolescens ages 15 o 19 and young aduls ages 20 o 24are a higher risk o acquiring SIs due o a combinaion o behavioral, biological, andculural reasons.
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In 2010 women ages 20 o 24 had he highes rae o chlamydia (3,407.9 cases per100,000 emales) compared wih any oher age or sex group. Chlamydia raes or women in his age group increased 6.9 percen rom 2009 o 2010.
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In 2010, as inprevious years, women ages 20 o 24 had he second highes rae o gonorrhea, while women ages 15 o 19 had he highes rae (560.7 cases per 100,000 emales) com-pared wih any oher age or sex group. From 2009 o 2010, gonorrhea raes or womenin his age group increased 3.8 percen.
Contraception is the fundamental reproductive health care need foryoung women
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Despie he common misconcepion ha eens are he mos likely age group oexperience an uninended pregnancy, women are mos a risk or an uninendedpregnancy during heir 20s. Among unmarried women who have ever experiencedan unplanned pregnancy, 54 percen are beween he ages o 20 and 29, while 31percen are under he age o 20. Only 15 percen o uninended pregnancies areamong women age 30 and older.
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Naionwide 1.5 million women ages 15 o 44 use oral conracepives exclusively or non-conracepive purposes. Bu more han hal o pill users (58 percen) rely on he mehoda leas in par or purposes oher han pregnancy prevenion. Tiry-one percen use ior cramps or mensrual pain, 28 percen or mensrual regulaion, 14 percen or acne, 4percen or endomeriosis, and 11 percen or oher unspecifed reasons.
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eenagers are more likely o use birh conrol pills or nonconracepive reasons hanolder women. Eighy-wo percen o young women ages 15 o 19 who use oral con-
3Center or American Progress | Young Women and Reproductive Health Care
racepives say hey do so or nonconracepive reasons. Among pill users ages 20 andolder, he overwhelming majoriy—90 percen—repor using he mehod or birhconrol, and 54 percen repor using he pill or is nonconracepive benefs, as well.
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Naionwide here are 18,404,500 women beween he ages o 18 and 29 in need o conracepive services and supplies.
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For hese women, conracepion use or preg-nancy prevenion and amily planning is a undamenal par o heir prevenive careand should be considered a basic par o heir primary healh care.
Young women are least likely to be able to afford contraception
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O he approximaely 19 million uninsured adul women in America, abou 5.3 mil-lion—28 percen—are ages 19 o 25.
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Women in heir 20s have been among he leaslikely o have healh insurance eiher because hey are no longer in school; no longereligible o say on heir paren’s insurance policy; working par-ime, emporary, orlow-wage jobs ha do no oer healh benefs; or some combinaion o he above.
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Te coss associaed wih consisen conracepion use can be dauning. I uninsured,a woman can ace more han $1,200 in annual coss or oral conracepives and relaeddocors’ appoinmens. Even an insured woman can spend more han $200 a year onher annual supply o oral conracepives and relaed docor’s appoinmens.
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Regardless o wheher a woman has insurance, her conracepive coss are a signifcanporion o her ou-o-pocke healh care spending. One sudy shows ha ou-o-pocke spending on oral conracepives accouned or 30 percen o privaely insured women’s healh care expenses and 68 percen o uninsured women’s ou-o-pockehealh care expenses. Te sudy also fnds ha ou-o-pocke spending on conracep-ion is highes or young women beween he ages o 21 and 30.
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Given ha he
average annual income or working aduls ages 18 o 34 is $27,458,
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hese coss presen real obsacles o young women’s access o care. One sudy showedha 55 percen o women ages 18 o 34 repored ha hey sruggled o pay or birhconrol, leading hem o use heir mehod inconsisenly or no a all.
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Researchshows ha even minimal co-pays or deducibles or prevenive services cause womeno delay reproducive care.
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Obamacare protects young women’s reproductive and sexual healthand well-being
Te Aordable Care Ac addresses many barriers ha young women ace in accessingaordable reproducive healh care. Mos imporanly, he law guaranees ha conracep-
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Young Women and Reproductive Health Care
Jessica Arons, Lucy Panza, and Lindsay Rosenthal explain why the Affordable Care Act helps young women access the health care they need in an affordable way.
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