Trends and determinants of reproductive health service use among young women in the USA.
BACKGROUND
This study explores the current patterns of reproductive health service use among young women in the USA and the changing influence of socio-demographic factors on the types of services used over time.


METHODS
The study population, drawn from the two last cycles of the National Survey of Family Growth, consists of women aged 15-24 (n = 2543 in 1995, n = 2157 in 2002). We examined trends in use of 'contraceptive services' and 'other reproductive health services for preventive care' and tested for changes in the patterns of use of these services over time. Logistic regression models were used to further clarify the factors associated with the use of the two types of services in 2002.


RESULTS
Results show no difference in the overall use of reproductive health services in the past year but did reveal changes in the type of service sought. Use of services for contraception increased by 10 percentage points (39.3% in 1995 to 49.7% in 2002, P < 0.001), although the use of other services remained stable (53.2% in 1995, 50.2% in 2002, P = 0.14). The patterns of use varied over time, exhibiting growing social disparities. In 2002, the use of contraceptive services depended on women's age, number of partners, personal and mother's level of education, and menstrual problems. The use of other reproductive health services for preventive care varied across women's socio-economic background.


CONCLUSIONS
This study demonstrates increasing social differentials in the use of reproductive health services for preventive care among young women in the USA between 1995 and 2002, a finding which calls for careful monitoring in the context of limited resources.
Potter
J
J
Department of Epidemiology, Demography, and Social Sciences, Institut National de la Santé et de la Recherche Médical, Unit 822, Le Kremlin-Bicêtre, France.
Trussell
J
J
Moreau
C
C
D000293:Adolescent; D000375:Aging; D003268:Contraception Behavior / Q000639:trends; D004522:Educational Status; D005193:Family Planning Services / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D008599:Menstruation Disturbances / Q000453:epidemiology; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult