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Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Objectives

Race differences in contraceptive use and in geographic access to pharmacies are well established. We explore race differences in characteristics of nearby pharmacies that are likely to facilitate (or not) contraceptive purchase.

Study Design

We conducted analyses with two geocode-linked datasets: (1) the Relationship Dynamics and Social Life (RDSL) project, a study of a random sample of 1003 women ages 18–19 living in a county in Michigan in 2008–09; and (2) the Community Pharmacy Survey, which collected data on 82 pharmacies in the county in which the RDSL study was conducted.

Results

Although young African-American women tend to live closer to pharmacies than their white counterparts (1.2 miles to the nearest pharmacy for African Americans vs. 2.1 miles for whites), those pharmacies tend to be independent pharmacies (59 vs. 16%) that are open fewer hours per week (64.6 vs. 77.8) and have fewer female pharmacists (17 vs. 50%), fewer patient brochures on contraception (2 vs. 5%), more difficult access to condoms (49% vs. 85% on the shelf instead of behind glass, behind the counter, or not available), and fewer self-check-out options (3 vs. 9%). More African-American than white women live near African-American pharmacists (8 vs. 3%). These race differences are regardless of poverty, measured by the receipt of public assistance.

Conclusions

Relative to white women, African-American women may face a “contraception desert,” wherein they live nearer to pharmacies, but those pharmacies have characteristics that may impede the purchase of contraception.

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Notes

  1. Thus, one limitation of the Community Pharmacy Survey is that these characteristics of pharmacy staff are measured with a higher degree of error than the other, directly observable characteristics of the pharmacy. We discuss this further in the “Limitations” section. Chi-square tests indicate no differences in pharmacy characteristics between the surveyed and the observed pharmacies (not shown in tables).

References

  1. Mosher WD, Jones J. Use of contraception in the United States: 1982-2008. Hyattsville, md: U.S. Dept. of health and human services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2010.

  2. Gaydos LM, Neubert BD, Hogue CJR, Kramer MR, Yang Z. Racial disparities in contraceptive use between student and nonstudent populations. J Women's Health. 2010;19:589–95.

    Article  Google Scholar 

  3. Frost JJ, Singh S, Finer LB. Factors associated with contraceptive use and nonuse, United States, 2004. Perspect Sex Reprod Health. 2007;39:90–9.

    Article  PubMed  Google Scholar 

  4. Krings KM, Matteson KA, Allsworth JE, Mathias E, Peipert JF. Contraceptive choice: how do oral contraceptive users differ from condom users and women who use no contraception? Am J Obstet Gynecol. 2008;198:e46–7.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kusunoki Y, Barber JS, Ela EJ, Bucek A. Black-white differences in sex and contraceptive use among young women. Demography. 2016;53:1399–428.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374:843–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Dehlendorf C, Foster DG, de Bocanegra HT, Brindis C, Bradsberry M, Darney P. Race, ethnicity and differences in contraception among low-income women: methods received by family PACT clients, California, 2001–2007. Perspect Sex Reprod Health. 2011;43:181–7.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Trussell J. Contraceptive failure in the United States. Contraception. 2011;83:397–404.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Culwell KR, Feinglass J. The association of health insurance with use of prescription contraceptives. Perspect Sex Reprod Health. 2007;39:226–30.

    Article  PubMed  Google Scholar 

  10. Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol. 2012;120:1291–7.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nearns J. Health insurance coverage and prescription contraceptive use among young women at risk for unintended pregnancy. Contraception. 2009;79:105–10.

    Article  PubMed  Google Scholar 

  12. DeNavas-Walt C, Proctor BD, Smith JC. Income, poverty, and health insurance coverage in the United States: 2008. Washington, D.C.: U.S. Government Printing Office; 2009.

    Google Scholar 

  13. van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. [cited 2018 May 10];40. Available from: https://insights.ovid.com/pubmed?pmid=11789627. Accessed 13 Feb 2019

  14. Becker D, Tsui AO. Reproductive health service preferences and perceptions of quality among low-income women: racial, ethnic and language group differences. Perspect Sex Reprod Health. 2008;40:202–11.

    Article  PubMed  Google Scholar 

  15. Downing RA, LaVeist TA, Bullock HE. Intersections of ethnicity and social class in provider advice regarding reproductive health. Am J Public Health. 2007;97:1803–7.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Salganicoff A, Ranji U, Beamesderfer A, Jurani N. Women and health care in the early years of the Affordable Care Act. Menlo Park: The Henry J Kaiser Family Foundation; 2014. [cited 2017 Jun 21], Available from: https://pdfs.semanticscholar.org/99b5/bee07e973fa0111b279cefc4365991575d9e.pdf. Accessed 13 Feb 2019.

    Google Scholar 

  17. Boggess JE. How can pharmacies improve access to emergency contraception? Perspect Sex Reprod Health. 2002;34:162–5.

    Article  PubMed  Google Scholar 

  18. Ehrle N, Sarker M. Emergency contraceptive pills: knowledge and attitudes of pharmacy personnel in Managua, Nicaragua. Int Perspect Sex Reprod Health. 2011;37:67–74.

    Article  PubMed  Google Scholar 

  19. Gardner JS, Hutchings J, Fuller TS, Downing D. Increasing access to emergency contraception through community pharmacies: lessons from Washington state. Fam Plan Perspect. 2001;33:172–5.

    Article  CAS  Google Scholar 

  20. Sampson O, Navarro SK, Khan A, Hearst N, Raine TR, Gold M, et al. Barriers to adolescents’ getting emergency contraception through pharmacy access in California: differences by language and region. Perspect Sex Reprod Health. 2009;41:110–8.

    Article  PubMed  Google Scholar 

  21. Van KK. Emergency contraceptive pills: dispensing practices, knowledge and attitudes of South Dakota pharmacists. Perspect Sex Reprod Health. 2005;37:19–24.

    Article  Google Scholar 

  22. Dennis A, Grossman D. Barriers to contraception and interest in over-the-counter access among low-income women: a qualitative study. Perspect Sex Reprod Health. 2012;44:84–91.

    Article  PubMed  Google Scholar 

  23. Grossman D, Grindlay K, Li R, Potter JE, Trussell J, Blanchard K. Interest in over-the-counter access to oral contraceptives among women in the United States. Contraception. 2013;88:544–52.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Landau S, Besinque K, Chung F, Dries-Daffner I, Maderes NM, McGhee BT, et al. Pharmacist interest in and attitudes toward direct pharmacy access to hormonal contraception in the United States. J Am Pharm Assoc. 2009;49:43–50.

    Article  Google Scholar 

  25. McIntosh J, Wahlin B, Grindlay K, Batchelder M, Grossman D. Insurance and access implications of an over-the-counter switch for a progestin-only pill. Perspect Sex Reprod Health. 2013;45:164–9.

    Article  PubMed  Google Scholar 

  26. Potter JE, McKinnon S, Hopkins K, Amastae J, Shedlin MG, Powers DA, et al. Continuation of prescribed compared with over-the-counter oral contraceptives. Obstet Gynecol. 2011;117:551–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Rafie S, Stone RH, Wilkinson TA, Borgelt L, El-Ibiary SY, Ragland D. Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects. Integr Pharm Res Pract. 2017;Volume 6:99–108.

    Article  Google Scholar 

  28. Griffin B, Stewart-Lynch A. Loosening controls on birth control: helping women get the care they need. Nashville, TN; 2018.

  29. Chisholm-Burns MA, Spivey CA, Gatwood J, Wiss A, Hohmeier K, Erickson SR. Evaluation of racial and socioeconomic disparities in medication pricing and pharmacy access and services. Am J Health Syst Pharm. 2017;74:653–68.

    Article  PubMed  Google Scholar 

  30. Qin JZ, Diniz CP, Coleman JS. Pharmacy-level barriers to implementing expedited partner therapy in Baltimore, Maryland. Am J Obstet Gynecol. 2018;218:504.e1–6.

    Article  Google Scholar 

  31. Qato DM, Daviglus ML, Wilder J, Lee T, Qato D, Lambert B. “Pharmacy deserts” are prevalent in Chicago’s predominantly minority communities, raising medication access concerns. Health Aff. 2014;33:1958–65.

    Article  Google Scholar 

  32. Spernak SM, Mintz M, Paulson J, Burke HB, Gadkari M, Faselis C, et al. Neighborhood racial composition and availability of asthma drugs in retail pharmacies. J Asthma. 2005;42:731–5.

    Article  PubMed  Google Scholar 

  33. Erickson SR, Workman P. Services provided by community pharmacies in Wayne County, Michigan: a comparison by ZIP code characteristics. J Am Pharm Assoc. 2014;54:618–24.

    Article  Google Scholar 

  34. Green CR, Ndao-Brumblay SK, West B, Washington T. Differences in prescription opioid analgesic availability: comparing minority and white pharmacies across Michigan. J Pain. 2005;6:689–99.

    Article  PubMed  Google Scholar 

  35. Morrison RS, Wallenstein S, Natale DK, Senzel RS, Huang LL. “We don’t carry that”: failure of pharmacies in predominantly nonwhite neighborhoods to stock opioid analgesics. N Engl J Med. 2000;342:1023–6.

    Article  CAS  PubMed  Google Scholar 

  36. Bernstein SL, Cabral L, Maantay J, Peprah D, Lounsbury D, Maroko A, et al. Disparities in access to over-the-counter nicotine replacement products in new York City pharmacies. Am J Public Health. 2009;99:1699–704.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Cooper HLF, Bossak BH, Tempalski B, Friedman SR, Des Jarlais DC. Temporal trends in spatial access to pharmacies that sell over-the-counter syringes in New York City health districts: relationship to local racial/ethnic composition and need. J Urban Health. 2009;86:929–45.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Gellad WF, Choudhry NK, Friedberg MW, Brookhart MA, Haas JS, Shrank WH. Variation in drug prices at pharmacies: are prices higher in poorer areas? Health Serv Res. 2009;44:606–17.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Fakih S, Batra P, Gatny HH, Kusunoki Y, Barber JS, Farris KB. Young women’s perceptions and experiences with contraception supply in community pharmacies. J Am Pharm Assoc (2003). 2015;55:255–64.

    Article  Google Scholar 

  40. Qato DM, Zenk S, Wilder J, Harrington R, Gaskin D, Alexander GC. The availability of pharmacies in the United States: 2007–2015. PLoS One. 2017;12:e0183172.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Vu K, Rafie S, Grindlay K, Gutierrez H, Grossman D. Pharmacist intentions to prescribe hormonal contraception following new legislative authority in California. J Pharm Pract. 2017;089719001773789.

  42. Davis AM, Taitel MS, Jiang J, Qato DM, Peek ME, Chou C-H, et al. A national assessment of medication adherence to statins by the racial composition of neighborhoods. J Racial Ethn Health Disparities. 2017;4:462–71.

    Article  PubMed  Google Scholar 

  43. Heller R, Johnstone A, Cameron ST. The feasibility of contraceptive injections at the community pharmacy. Eur J Contracept Reprod Health Care. 2017;22:327–33.

    Article  CAS  PubMed  Google Scholar 

  44. Taylor SD, Frazier M, Shimp LA, Boyd EL. Implementing pharmaceutical care in an inner city pharmacy: hypertension management and elderly African Americans. J Aging Pharmacother. 2003;13:63–76.

    Article  Google Scholar 

  45. Callegari LS, Parisi SM, Schwarz EB. Perceptions of intrauterine contraception among women seeking primary care. Contraception. 2013;88:269–74.

    Article  PubMed  Google Scholar 

  46. O’Connell MB, Korner EJ, Rickles NM, Sias JJ. Cultural competence in health care and its implications for pharmacy. Pharmacotherapy. 2007;27:1062–79.

    Article  PubMed  Google Scholar 

  47. Malat J, van Ryn M. African-American preference for same-race healthcare providers: the role of healthcare discrimination. Ethn Dis. 2005;15:740.

    PubMed  Google Scholar 

  48. Ashwood D, Farris KB, Campo S, Aquilino M, Losch M. Unlocking the condoms: the effect on sales and theft. Pharm Pract. 2011;9:44–7.

    Google Scholar 

  49. Amsler MR, Murray MD, Tierney WM, Brewer N, Harris LE, Marrero DG, et al. Pharmaceutical care in chain pharmacies: beliefs and attitudes of pharmacists and patients. J Am Pharm Assoc. 2001;41:850–5.

    CAS  Google Scholar 

  50. Martinez G, Copen CE, Abma JC. Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006-2010 National Survey of family growth. Vital Health Stat 2011;23.

  51. Manlove J, Terry-Humen E. Contraceptive use patterns within females’ first sexual relationships: the role of relationships, partners, and methods. J Sex Res. 2007;44:3–16.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Bower KM, Thorpe RJ Jr, Rohde C, Gaskin DJ. The intersection of neighborhood racial segregation, poverty, and urbanicity and its impact on food store availability in the United States. Prev Med. 2014;58:33–9.

    Article  PubMed  Google Scholar 

  53. Gilliam ML, Davis SD, Neustadt AB, Levey EJ. Contraceptive attitudes among inner-city african american female adolescents: barriers to effective hormonal contraceptive use. J Pediatr Adolesc Gynecol. 2009;22:97–104.

    Article  PubMed  Google Scholar 

  54. Cheung E, Free C. Factors influencing young women’s decision making regarding hormonal contraceptives: a qualitative study. Contraception. 2005;71:426–31.

    Article  PubMed  Google Scholar 

  55. Jones J, Mosher W, Daniels K, et al. Current contraceptive use in the United States, 2006–2010, and changes in patterns of use since 1995. Natl Health Stat Rep. 2012;60:1–25.

    Google Scholar 

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Acknowledgments

The authors gratefully acknowledge the Survey Research Operations (SRO) unit at the Survey Research Center of the Institute for Social Research for their help with the data collection, particularly Vivienne Outlaw, Sharon Parker, and Meg Stephenson. The authors also gratefully acknowledge the intellectual contributions of the other members of the original RDSL project team, William Axinn, Mick Couper, and Steven Heeringa, as well as the Advisory Committee for the project: Larry Bumpass, Elizabeth Cooksey, Kathie Harris, and Linda Waite.

Funding Statement

This research was supported by three grants from the National Institute of Child Health and Human Development (R01 HD050329, R01 HD050329-S1, U54 HD093540), a grant from the National Institute on Drug Abuse (R21 DA024186), and a population center grant (R24 HD041028) and training grant (T32HD007339) from the National Institute of Child Health and Human Development to the University of Michigan’s Population Studies Center. Funders did not participate in data collection or analysis or the writing of this manuscript.

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Authors and Affiliations

  1. Department of Sociology, University of Michigan, 500 S. State St., Ann Arbor, MI, 48109, USA

    Jennifer S. Barber

  2. Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI, 48104, USA

    Jennifer S. Barber, Heather Gatny, Yasamin Kusunoki & Peter Batra

  3. Population Research Center, University of Michigan, 305 E. 23rd Street, Austin, MI, TX 78712, USA

    Elizabeth Ela

  4. School of Nursing, University of Michigan, 400 N. Ingalls, Ann Arbor, MI, 48109, USA

    Yasamin Kusunoki

  5. School of Pharmacy, Chapman University, 9401 Jeronima Road, Irvine, CA, 92618, USA

    Souhiela Fakih

  6. College of Pharmacy, University of Michigan, 428 Church St., Ann Arbor, MI, 48109, USA

    Karen Farris

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  1. Jennifer S. Barber
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Correspondence to Jennifer S. Barber.

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Appendix

Appendix

Table 5 Comparison of characteristics of pharmacies within five miles, by race and poverty, Relationship Dynamics and Social Life (RDSL) study, Michigan, 2008–2009 (n = 961 women, except where noted)
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Table 6 Comparison of characteristics of nearest pharmacy, by race and receipt of public assistance, Relationship Dynamics and Social Life (RDSL) study, Michigan, 2008–2009 (n = 961 women, except where noted)
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Barber, J.S., Ela, E., Gatny, H. et al. Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies. J. Racial and Ethnic Health Disparities 6, 719–732 (2019). https://doi.org/10.1007/s40615-019-00570-3

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