Increased access to highly effective contraception: an opportunity dividend?

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Project Summary Over the last 50 years, access to contraception in the US has been supported by dedicated public funding streams. Benefits to women's lives are often cited as rationale for these programs. But there is surprisingly little rigorous contemporary evidence to support the claim that access to highly effective contraception – as opposed to use of it – impacts women's economic outcomes and human capital accumulation at the population level. This absence of evidence leaves a dominant rationale for the public subsidy of contraception untested. This project seeks to overcome challenges in data and research design that resulted in this lack of evidence. In partnership with the U.S. Census Bureau, the project will (Aim 1) construct an individual-level longitudinal dataset, Reproduction in People's Lives (RIPL), recording women's fertility and women's and men's human capital formation for nearly all reproductive-age U.S. residents 2007-2021. It will link restricted individual-level microdata for the entire United States from the 2010 Census, IRS tax filings, the Census Household Composition Key File, Medicaid Eligibility Records, and the 2007-2021 American Community Surveys (ACS). The project will estimate the causal impact of access to contraception using a massive policy experiment: the Colorado Family Planning Initiative (CFPI), begun in 2009, which dramatically expanded access to highly effective contraception in all federally funded Title X clinics in Colorado, making previously expensive methods free. Vital statistics analyses showed CFPI decreased young women's fertility and abortion rates in Colorado compared to prevailing trends in other states. A pilot for this project used linked Census and ACS data (to be included in RIPL) to study effects of CFPI on education, finding that CFPI improved high school completion. Changes in life course outcomes as Coloradans gained access to highly effective contraception will be compared to changes in comparison states using a difference-in-differences approach. In this way the project will (Aim 2) assess the impact of access to highly effective contraception on women's fertility over their life course. Similarly, the project will (Aim 3) assess the impact of access to highly effective contraception on women's (and for the first time, men's) economic outcomes and human capital accumulation. For each outcome, whether impacts vary by age at exposure, family of origin socioeconomic status, and race/ethnicity, as well as whether fertility mediates the impact of CFPI on women's socioeconomic lives will be assessed. Project findings will inform longstanding debates in demography, economics, and public policy regarding the consequences of family planning programs, the degree to which individuals may improve their economic opportunity by controlling their fertility, whether observed associations between fertility timing and women's later life outcomes are causal, and whether empowering women to control their fertility reduces the negative socioeconomic consequences of childbearing for women. The data and methods developed by the project may also be used to investigate effects of other family planning and social policy changes.