January 26, 2012 — Summary of "Access to Emergency Contraception for Adolescents," Wilkinson et al., Journal of the American Medical Association, Dec. 19, 2011.
"A disproportionate number of teen pregnancies occur among adolescents from disadvantaged neighborhoods," but the "availability and accessibility of emergency contraception in these neighborhoods relative to more affluent ones is unknown," according to Tracey Wilkinson and colleagues from Boston Medical Center and the Boston University School of Public Health. The researchers developed a study to "understand differences in availability of and access to emergency contraception across low- and non-low-income U.S. neighborhoods."
Female research assistants posing as 17-year-olds who recently had unprotected intercourse called pharmacies in Austin, Texas; Cleveland, Ohio; Nashville, Tenn.; Philadelphia, Pa.; and Portland, Ore., from September 2010 through December 2010. The callers followed a script to determine whether EC was available the same day at the pharmacy, whether EC could be accessed by the caller and whether the pharmacist knew the correct age (17) at which EC is available without a prescription.
The researchers used 2010 Census data to determine the income levels in the neighborhoods where the pharmacies were located. They considered neighborhoods to be low-income if the median household income in the area was at or below 200% of the poverty level.
The researchers included calls to 916 commercial pharmacies in their analysis. About 47% of the pharmacies were located in low-income neighborhoods.
Eighty percent of pharmacies had EC available the same day, and availability of EC did not change based on neighborhood income, the researchers found. Callers were told they could not obtain EC under any circumstances about 19% of the time, and this misinformation was more common in pharmacies in low-income neighborhoods. The researchers wrote, "In all but 11 calls, the incorrect age was stated as erroneously too high, potentially restricting access."
Although the majority of pharmacies offered same-day availability of EC, "misinformation regarding access was common -- particularly in low-income neighborhoods," the researchers wrote. They noted that the study design did not assess why disparities in access to EC exist, but "possible explanations include differences in pharmacy staffing or training, frequency of requests for information or organizational cultures around customer service." They added, "Limitations withstanding, the finding that misinformation regarding [EC] access is more common in low-income neighborhoods, which have higher teen pregnancy rates, suggests that targeted education for consumers and pharmacy staff may be necessary."
Debra Ness, publisher & president, National Partnership
Andrea Friedman, associate editor & director of reproductive health programs, National Partnership
Marya Torrez, associate editor & senior reproductive health policy counsel, National Partnership
Melissa Safford, associate editor & policy advocate for reproductive health, National Partnership
Perry Sacks, assistant editor & health program associate, National Partnership
Cindy Romero, assistant editor & communications assistant, National Partnership
Justyn Ware, editor
Amanda Wolfe, editor-in-chief
Heather Drost, Hanna Jaquith, Marcelle Maginnis, Ashley Marchand and Michelle Stuckey, staff writers
Tucker Ball, director of new media, National Partnership