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Spatial Accessibility of Reproductive Health Care Services Following Dobbs v. Jackson Woman's Health Organization

Dr. Gia Barboza-Salerno, Health Behavior and Health Promotion I Social Work
Rank at time of award: Assistant Professor
and
Dr. Jacquelyn C.S. Meshelemiah, Social Work
Rank at time of award: Associate Professor
and
Dr. H.B. Franchino-Olsen, Health Behavior and Health Promotion
Rank at time of award: Faculty Fellow
and
Dr. Alison Norris, Infectious Diseases and Medicine
Rank at time of award: Professor

The Supreme Court's decision in Dobbs v. Jackson's Women's Health Organizationl ("Dobbs") eliminated all existing federal constitutional protections for abortion, and declared that the constitutionality of any new abortion law and/or regulation will be reviewed using the rational basis test. Immediately following Dobbs, several states enacted bans to either severely restrict abortion access or ban abortion outright. The State of Ohio, for example, implemented a ban on abortions after cardiac activity is detected, around 6 weeks of pregnancy. State bans and restrictions on abortions have reduced access to the full range of reproductive health care possible, particularly for Black, Indigenous, and other women of color. In turn, women who are denied access to reproductive health care, including but not limited to, access to abortion care, experience more life-threatening pre- and post-pregnancy health complications, have higher levels of food, housing and transportation insecurity, and are more likely to be involved in abusive relationships. To better understand the fine-grained spatiotemporal patterns in accessibility to reproductive health care due to socioeconomic, housing and transportation/population mobility disadvantage for women following the restrictions placed on abortion, as well as determinants of those disadvantages, this research intends to: 

(1) identify, download, categorize, and map reproductive health care facilities across the United States;

(2) evaluate changes in geographic accessibility, defined as distance and time traveled to the nearest facility, and the number of facilities accessible conditioned by both travel time and mode of travel (foot, bus, train, car), to reproductive health care facilities;

(3) assess whether regional disparities in accessibility exist following the implementation of abortion bans and restrictions post-Dobbs across levels of socioeconomic, housing and transportation disadvantage. 

This study explores geographical accessibility to reproductive health care facilities, including abortion providers, pre- and post- Dobbs using rapid realistic routing based on different travel and departure times, and modes of travel (i.e., by foot, bus, railway, and car), making it possible to identify regional disparities in women's reproductive health outcomes across areas of socioeconomic, housing and transportation disadvantage in the future.