Cristina Richie

Population Growth, Birth Control & Income

According to the 2010 U.S. Census, the Hispanic/Latino population rose 43% from 2000-2010, accounting for 16.3% of the total American population, while the non-Hispanic/Latino population rose only 4.9% in the same amount of time, comprising 83.7% of the population.1

In addition, Hispanic households are more likely to be affected by poverty.2 A full 29% of households with a Hispanic origin householder were below the $19,999 annual income poverty line, compared to 27.1% of households with a white alone householder in this category. This shows a less than 2% difference in poverty by race, but when the same groups are analyzed for secure financial situations, Hispanics were less likely to be well off when compared to white households. In the same economic census, only 38% of households with a Hispanic origin earned $50,000 or more, compared with 50.8% of households with a white alone, not Hispanic householder. Here the income gap for the financially secure is over 12% by race. 3

Health Insurance and Income

How this affects the availability of health insurance may be one factor in the tremendous population growth that America experienced from 2000-2010. Simply put, women who can afford health insurance, or whose employer provides it, will typically have better access to OB/GYN's for family planning services. But even with health insurance, co-pays and office visits still play a part in a woman's choice of birth control.

A whopping "three-quarters of American women of childbearing age rely on employer-sponsored plans for their health coverage, according to the Alan Guttmacher Institute…yet half of all large group-insurance plans do not cover any form of prescription contraception, and only a third cover the Pill."4 With limited coverage, women are digging into their own pockets to pay for contraception, and even with insurance, "co-payments for birth control pills typically range between $15 and $50 per month, and for other methods, such as IUDs, co-pays and other out-of-pocket expenses can reach into the hundreds of dollars."5 Likewise those who do not have health insurance, or the ability to pay for effective contraception will have to pay out of pocket, or may forgo birth control, and instead accidentally or unintentionally become pregnant.

The Uninsured and Birth Control

Without health insurance, doctor's visits can cost upwards of $100, with birth control costing anywhere from $60 to $600 per year, excluding free methods such as abstinence and fertility awareness, and permanent methods like sterilization [see figure 1]. Planned Parenthood, one of the largest suppliers to young and needy women, states that 75% of their health care clients have incomes at or below 150% of the federal poverty level.6 Some clients are teenagers, as they are both young and typically without the financial means for contraception, but slightly older women as well, who are either still in school and therefore not financially secure, or who have finished school, but who are financially under-resourced, face the challenges of securing birth control at a reasonable cost. Therefore they turn to Planned Parenthood. Through low—and no—cost contraceptive programs, this Title X provider eliminates one of the factors affecting birth control use: money.

Cost is a factor in choosing a birth control method, and in an alarming trend, "3% of women report having stopped using a birth control method in the past year [2008] because they couldn't afford it. Among women currently using a hormonal method, this doubles to 6%"7. Without preventative measures, pregnancy is likely: 85% of all couples not using birth control will become pregnant within a year.8

These preventable, unintentional pregnancies put pressure on the amount of resources America can provide to her inhabitants; yet many women, for financial or other reasons, simply do or will not seek the birth control methods necessary to halt rapid population growth. And while woman across all socio-economic and demographic categories may choose to have as many or as few children as she and her partner desire, there are certain trends in the number of children born per women by demographic group.

Factors Affecting Fertility

The number of children born per woman in America is affected by race. The most recent figures released by the U.S. Census has documented that while the average number of children born per woman in all races is 2.57, a woman in a white alone household will have a slightly lower number of children, on average, at 2.41, and a woman in a Hispanic origin of household averages an entire child higher at 3.41.9 For all women, this shows an increase from the year 2000 reproduction levels when the average rate of children born per women by the age of 40-44 was 2.5 for Hispanic, 2.1 for African-American, and 1.8 for white women.10 This trend have been corroborated in teenage women of the same races,11 and speaks to the likely connection between beginning reproduction at an early age and leaving the reproductive years with more children. In other words, delaying childbearing results in lower fertility rates.

So why are some women using birth control, and others not? The discrepancy between birth control use comes down to money among other factors like race, education [see figure 2], and religion. While well-to-do women are more likely to have health insurance than poorer women, health insurance in itself does not necessitate better access to birth control, or less money spent on contraception, especially when monthly premiums are factored in. This evidence was confirmed by a study published in the Oxford Journal of Medicine that noted fertility declines not with contraception, but with other societal factors.12 However, access to insurance does indicate a socio-economic status whereby the amount paid for contraception is a lower percentage of one's income.

Regardless of all the reasons why some women have more children than others, making birth control widely available to all women makes economic sense. It is far cheaper to provide birth control than to pay for an abortion, or a pregnancy. Finances must no longer be even one factor in the decision to use reproductive health services.

Curbing reproduction to sustainable levels is essential to turn back the trend of an exploding population in America.

1 http://2010.census.gov/2010census/data/index.php

2As defined by the US Census as $13,991 for two person families and $17,098 for three person families. http://www.census.gov/hhes/www/poverty/data/threshld/thresh09.html

3 Income is rounded up to the next closest income bracket for a three person family to $19,999, as determined by the US Census Income Distribution Measures by Definition of Income: 2009 Annual Social and Economic (ASEC) Supplement http://www.census.gov/hhes/www/cpstables/032010/rdcall/1_011.htm [for white tables] http://www.census.gov/hhes/www/cpstables/032010/rdcall/1_016.htm [for Hispanic tables] 

4 Loren Stein, "Covering Birth Control" Web MD Feature, 1/30/2005. http://www.medicinenet.com/script/main/art.asp?articlekey=51391

5 Planned Parenthood, "Birth Control Matters: Making Prescription Birth Control Affordable for America's Women" http://www.plannedparenthood.org/ppgnw/birth-control-matters-32835.htm 

6 Planned Parenthood, "Planned Parenthood by the Numbers". http://www.plannedparenthood.org/about-us/newsroom/politics-policy-issues/fact-sheets-reports-32754.htm

7 The American College of Obstetricians and Gynecologists (ACOG) NEWS RELEASE New Gallup Survey Reveals Disturbing Trends, "Bad Economy Blamed for Women Delaying Pregnancy and Annual Check-Up" May 5, 2009.

8 Kimberly Palmer, "The Real Cost of Birth Control", Alpha Consumer Posted: August 27, 2010.

9 US Census, "America's Families and Living Arrangements: 2009, Average Number of People per Household, by Race and Hispanic Origin, Marital Status, Age, and Education of Householder: 2009" http://www.census.gov/population/www/socdemo/hh-fam/cps2009.html

10 Planned Parenthood, "The Population Profile of the United States: 2000", MOTHERHOOD: The Fertility of American Women, 2000

11 In 2009 the birthrate for teens aged 15–19 was 70.1 per 1,000 for Hispanics, 59 per 1,000 for African Americans, and 25.6 per 1,000 for whites, decrease from 2006, when the pregnancy rate for Hispanic teens was 126.6 per 1,000. For African- American teens it was 126.3 per 1,000. The pregnancy rate for non- Hispanic white teens was 44 per 1,000 women 15–19 years of age.

Guttmacher Institute, U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity (New York: Guttmacher Institute), 2010.