Health disparities and infertility: impacts of state-level insurance mandates
Health disparities and infertility: impacts of state-level insurance mandates
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DOI：
10.1016/j.fertnstert.2005.11.038
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发表时间：
2006-04-01
影响因子：
6.7
通讯作者：
Schmidt, L
中科院分区：
文献类型：
--
作者：
Bitler, M;Schmidt, L
目的：确定在不孕症、生殖力受损或不孕症治疗中是否存在重要的种族、民族或社会经济地位（SES）健康差异。设计：汇总了全国家庭成长调查（NSFG）的四波数据。对不同种族/民族、教育程度和年龄组的测量结果进行了比较。参与者：收集了来自NSFG的31,047名15-44岁女性的数据。干预措施：通过妇女居住的州是否有强制要求（至少在访谈前一年）强制保险公司支付或提供不孕症治疗来比较结果。主要结局指标：不孕状况，生育能力受损，曾寻求不孕治疗。结果：不孕不育在非西班牙裔黑人妇女、非西班牙裔其他种族妇女和西班牙裔妇女中比在非西班牙裔白人妇女中更为常见，在高中辍学者和没有上过大学的高中毕业生中比在4年大学毕业生中更常见，在年龄较大的妇女中比在29岁及以下的妇女更常见。老年妇女、非西班牙裔白人妇女和受教育程度较高（至少上过一些大学）的妇女更有可能接受过治疗。没有证据表明种族、民族或教育差异因医疗保险规定而得到改善。结论：在不孕状况和治疗方面存在种族、民族和教育差异，在生殖力受损方面存在教育差异。需要对不孕症治疗任务对这些差异的影响进行更多的研究。
Objective: To determine whether important racial, ethnic, or socioeconomic status (SES) health disparities exist in infertility, impaired fecundity, or infertility treatment.Design: Four waves of the National Survey of Family Growth (NSFG) were pooled. Measures were compared across various race/ethnicity, education, and age groups.Participant(s): Data for 31,047 women 15-44 years old from the NSFG were pooled.Intervention(s): Outcomes were compared by whether the women's states of residence bad a mandate in place (at least I year before the interview) to compel insurers to cover or offer to cover infertility treatment.Main Outcome Measure(s): Infertility status, impaired fecundity, ever having sought infertility treatment.Result(s): Infertility is more common for non-Hispanic black women, non-Hispanic other race women, and Hispanic women than for non-Hispanic white women, and both infertility and impaired fecundity are more common for high school dropouts and high school graduates with no college than for 4-year college graduates, and for older women compared with women 29 and younger. Older women, non-Hispanic white women, and women who are more educated (with at least some college) are more likely to have ever received treatment. No evidence has been found that the racial, ethnic, or education disparities are ameliorated by the health insurance mandates.Conclusion(s): Racial, ethnic, and educational disparities exist in infertility status and treatment, and educational disparities in impaired fecundity. More study of the impact of infertility treatment mandates on these disparities is needed.