Disparities in Distance to Abortion Care Under Reversal of Roe v. Wade
As abortion-restricting legislation has been enacted at the state level, spatial disparities in abortion care access have grown. With the Supreme Court’s expected majority ruling to strike down Roe v. Wade, access to abortion care will likely become substantially worse in large regions of the country. State-level bans could severely reduce access in vast regions, worsening access in areas with already poor access. This may exacerbate disparities and lead to large-scale impacts on reproductive health.
Spatial Analysis and Methodology
We conducted an ecological and spatial analysis of abortion facilities and county-level populations in the contiguous United States (CONUS). A list of 1,045 abortion clinics was obtained from the Advancing New Standards in Reproductive Health (ANSIRH) group’s Abortion Facilities Database. Outcomes were Euclidean distance to abortion care, as well as change in distance after policy changes.
Key Findings on Access and Distance
If states enact abortion bans as expected, 46.7% of the country’s women would see an increase in distance to abortion care. In particular, women in the Deep South, Midwest, and Intermountain West could have to travel much farther for care. The following data highlights the projected shifts in access:
- Current proximity: More than half (62.6%) of all U.S. women live within 10 miles of an abortion clinic.
- Post-ban proximity: If state-level abortion bans go into effect, only 40.2% of women would live that close.
- Median distance: The median distance would increase from 38.9 miles to 113.5 miles.
Demographic and Socioeconomic Impacts
Beyond describing where abortion care may change, we sought to describe which populations could experience the most dramatic impacts if state-level bans are enacted. The impacts of state-level abortion bans will span across racial, ethnic, and socioeconomic demographics, but the effects will be felt disproportionately by Black, Hispanic/Latinx, and impoverished women and those with less education.
When abortion access is restricted, women seeking an abortion experience more stress, incur more out-of-pocket expenses, and must travel farther to obtain care. Restricting access to abortion services is also associated with adverse maternal and infant health outcomes. The changes have potential to exacerbate disparities in maternal healthcare outcomes at a large scale.