title: Natural and social disasters: racial inequality in access to contraceptives after Hurricane Ike.
abstract: BACKGROUND
  Few data are available on access to contraception following a natural disaster. The current study extends the literature by examining access to various types of birth control in a large sample of women from diverse backgrounds following Hurricane Ike, which made landfall on September 13, 2008, on the upper Texas Gulf Coast.
  
  
  METHODS
  We examined Hurricane Ike's influence on access to contraceptives through survey results from 975 white, black, and Hispanic women 16-24 years of age receiving care at one of five publicly funded reproductive health clinics in the Texas Gulf Coast region between August 2008 and July 2010.
  
  
  RESULTS
  Overall, 13% of women reported difficulties accessing contraception. Black women had more difficulty than their white (p<0.001) and Hispanic (p=0.019) counterparts. Using multivariate analysis, we found that although family planning clinics in the area were open, black women (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.37-3.73; p=0.001] and hurricane evacuees (OR 2.17, 95% CI 1.27-3.72; p=0.005) reported greater difficulty in accessing birth control. Last, we found that a lack of access to birth control was related to having a higher frequency of unprotected sex for women of all races (p=0.001).
  
  
  CONCLUSIONS
  Access to resources is critical in differentiating the level of impact of disasters on various groups of people. We suggest a community-based disaster preparedness and response model that takes women's reproductive needs into account.
authors.affiliation: Center of Interdisciplinary Research in Women's Health, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77555, USA.
authors.forename: Ophra
authors.initials: O
authors.lastname: Leyser-Whalen
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rahman
authors.forename: Abbey B
authors.initials: AB
authors.lastname: Berenson
mesh_terms: D000293:Adolescent; D044383:Black People / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000208:ethnology*; D004190:Disasters; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D015999:Multivariate Analysis; D012923:Social Class; D012931:Social Environment; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult