Exploring financial stress and resource deprivation as barriers to preferred contraceptive use in Wisconsin in 2021

Abstract

Objective: This study assessed a broad array of socioeconomic barriers in relation to preferred contraceptive use during a time of exacerbated personal and social financial strain (the COVID-19 pandemic).

Study design: Using statewide data collected in early 2021 through the Survey of the Health of Wisconsin, we conducted bivariate analyses exploring the relationship between socioeconomic resources and preferred contraceptive use among Wisconsin women.

Results: The survey garnered 1889 responses, with a response rate of 34%. The sample for the current study (N = 247) included only adult women of reproductive age who reported current contraceptive use. Nearly one-third (32.8%) of contraceptive users reported that they were not using their preferred method. We found that greater resource deprivation, including housing instability (had to relocate: p = 0.004; unable to pay rent and/or mortgage: p = 0.008), food insecurity (ran out of food: p = 0.003; worried about running out of food: p = 0.008), and greater financial stress (p < 0.001), were significantly associated with lowered likelihood of using one's preferred contraceptive method.

Conclusions: Findings indicated that people lacking socioeconomic resources, including adequate food and housing, may be unable to access their preferred contraceptive method(s). Amidst competing demands on time and resources, the inability to obtain preferred contraceptive method(s) may represent system-wide barriers as well as people's lowered ability to prioritize and access care in light of socioeconomic struggles.

Implications: Health care providers and health systems should work to address structural barriers to care and bolster community resources in ways that promote patients' reproductive autonomy. There is also a need for continued research on specific socioeconomic determinants of preferred contraceptive use and potential solutions that bolster community resources.

Keywords: COVID-19; Contraceptive preference; Food insecurity; Housing instability; Reproductive autonomy; Socioeconomic resources.