PRB

The Challenge

In the United States, more than 19 million women aged 13 to 44 live in contraceptive deserts—areas with insufficient access to the full range of contraceptive methods—and this burden disproportionately affects women of color. Key barriers to contraceptive access include cost, health insurance gaps, widespread misinformation and disinformation, bias, and health care provider shortages. These barriers unduly impact individuals who are already marginalized based on factors such as age, income, race/ethnicity, geographic area, education level, and/or exposure to violence.

Many of the barriers to contraceptive access in the United States are directly or indirectly shaped by federal and state policies. This patchwork of policies has created a tiered system that promotes or inhibits access to effective and affordable contraceptive care based on a person’s state of residence. Such a confusing policy landscape is detrimental to patients seeking information and care and to policymakers and advocates working to expand and protect access to contraceptive services.

Our Approach

In State of Access—funded by Arnold Ventures—PRB aims to create a tool that assesses the extent to which each U.S. state’s policy environment enables and supports access to contraceptives. To provide clarity to the confusing policy landscape governing contraceptive access in the United States, the State of Access Scorecard will compile and synthesize evidence on contraceptive access policy in two ways:

1. We will identify policy and program interventions that provide evidence in support of increased contraceptive access and develop a framework that gauges the favorability of state-level policy environments for contraceptive access.
2. Using various existing databases, we will populate indicator data into a scorecard so users can easily interpret and compare state policy environments for contraceptive access.

Impact

State of Access will disentangle the complex, fractured environment for contraceptive access and reproductive health outcomes in the United States. It will provide a comprehensive, evidence-based, nonpartisan, accessible resource that a range of audiences—including policymakers, journalists, program implementers, donors, and advocates—can use to propel their practice and policymaking.