title: Social disparities in women's health service use in the United States: a population-based analysis.
abstract: OBJECTIVE
  Poor and disparate reproductive health outcomes in the United States may be related to inadequate and differential receipt of women's health care. We investigated trends in and determinants of adult U.S. women's health service use, 2006-2010.
  
  
  METHODS
  We analyzed population data from 7897 women aged 25-44 years in the National Survey of Family Growth from 2006 to 2010 using multivariable logistic regression.
  
  
  RESULTS
  Women's health service use in the past year was reported by 74% of the sample. Among noninfertile, sexually active women, 47% used contraceptive services; fewer used pregnancy (21%) and sexually transmitted infection (14%) services. In multivariable models, the odds of service use were greater among older, poor, unemployed women and women with less educational attainment than younger and socioeconomically advantaged women. Black women had greater odds of using pregnancy, sexually transmitted infection and gynecologic examination services than white women (odds ratio, 1.4-1.6). Lack of insurance was associated with service use in all models (odds ratio, 0.4-0.8).
  
  
  CONCLUSIONS
  Although age-related differences in women's health service use may reflect fertility transitions, social disparities mirror reproductive inequalities among U.S. women. Research on women's health service use and outcomes across the reproductive life course and forthcoming sociopolitical climates is needed.
authors: Department of Obstetrics and Gynecology, Institute for Social Research, University of Michigan, Ann Arbor. Electronic address: hkelli@umich.edu.
authors: Kelli Stidham
authors: KS
authors: Hall
authors: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor.
authors: Vanessa
authors: V
authors: Dalton
authors: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor.
authors: Timothy R B
authors: TR
authors: Johnson
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D011159:Population Surveillance; D011247:Pregnancy; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States; D016387:Women's Health; D014932:Women's Health Services / Q000706:statistics & numerical data*
keywords: Preventive reproductive health care; Social determinants of health; Women's health services