Experiences of everyday discrimination, inside or outside medical settings, can take a significant toll on Latina women’s comfort with reproductive health services, according to a new study published in the journal Women’s Health Issues.
The findings show that young Latina women who have experienced racial or ethnic discrimination are less satisfied overall with their contraceptive care, which could affect their access to more effective contraceptives.
“It is a positive finding that three-quarters of the women in our study reported being satisfied with their contraceptive care, but among the quarter that reported being unsatisfied, their experience with discrimination and its negative effects on satisfaction could severely affect their contraceptive use experience,” said Lisa Oakley, Ph.D., the study’s lead author and a postdoctoral researcher in the College of Public Health and Human Sciences at Oregon State University (OSU).
“That’s really important because a lack of access to effective birth control contributes to increased rates of unintended pregnancy.”
The aim of the study was to better understand the factors that may impact Latinas’ satisfaction with contraceptive services. A total of 211 women, ages 18-25, participated in the study, which included surveys and interviews.
About 40 percent of the participants were born in the U.S. and about 60 percent were born outside the U.S. Among the foreign-born, the average length of U.S. residency was 8.4 years, with a range of less than six months to 24 years.
Initially, the researchers found that experiences of discrimination, medical mistrust and structural barriers to care, such as trouble with childcare or getting time off work to see a doctor, were tied to low satisfaction. But when considering all of these influences together, they found that everyday instances of discrimination had the biggest impact on women’s satisfaction.
The perceived discrimination cited by women in the study involved going to the bank, buying groceries or finding a place to live, Oakley said. It is rooted in the larger environment and culture of a community, but impacts individuals’ satisfaction with health care.
It is important for young women of reproductive age to have access to effective contraceptives to prevent unintended pregnancies, according to researchers. The most effective methods of birth control, including hormonal pills or implantable devices, can only be obtained through a medical provider.
“The causes of unintended pregnancy are broad, but one reason is a lack of access to birth control,” said S. Marie Harvey, Ph.D., co-author of the study and associate dean and distinguished professor at OSU’s College of Public Health and Human Sciences. “Those who lack access are at higher risk of becoming pregnant, regardless of the individual’s behavior. It’s a systemic issue.”
According to the findings, 83 percent of the study participants had seen a health care provider for birth control services in the past, and of those, nearly 90 percent reported receiving birth control services in the past year.
Around 75 percent of the women reported being very or extremely satisfied with their birth control services. Among the remaining women, the most significant reason for dissatisfaction was perceived racial or ethnic discrimination.
“Ensuring health care providers have culturally responsive staff and reducing other barriers to access, such as child care, transportation and unemployment, can help women feel more satisfied with their overall care,” said Harvey. “And satisfaction with care helps to ensure that women will continue to seek medical care, including contraceptives.”
However, since everyday discrimination was the key driver of women’s dissatisfaction in this study, it is important to look outside the health care system and into the larger community to identify places where discrimination can be addressed, Oakley added.
The research sheds light on Latinos’ health care experiences in non-traditional but fast-growing settlement areas such as rural Oregon, where Latino populations have grown significantly but the systems to support them have not kept pace, said Daniel López-Cevallos, Ph.D., assistant professor of ethnic studies in OSU’s College of Liberal Arts.
“Latinos in these areas may not have access to societal supports and resources such as health care that are found in more traditional settlement areas,” he said. “They also may be exposed to more discrimination than in areas that do not have a history of Latino settlement.
“Those early, negative experiences can have a long-term impact on their lives and their decisions about health care.”
Source: Oregon State University