Document Type
Article
Publication Date
2025
Advisor
Jeannette Manger
Abstract
Background: As policy pertaining to female reproductive health and education continues to be a central issue concerning Americans and a divisive focus of political campaigns, it is important to fully understand the ramifications of female reproductive health legislation not only on women’s health outcomes but also the health outcomes of children and adolescents.
Objective: We set out to identify how legislation and policy related to female reproductive health and education impacts the health and well-being of children and adolescents. By evaluating this relationship, we aim to show whether variations in policy correlate with variations in a child’s well-being as lawmakers claim.
Methods: The data we used for our research comes from the County Health Rankings & Roadmaps website, which receives its annual data from national and state data sources. Child and infant mortality rates are from the National Center for Health Statistics - Mortality Files. Low birth weight and teen birth rate come from the National Center for Health Statistics - Natality files. Children in poverty data is from the Small Area Income and Poverty Estimates. Children in single parent households' data is from the American Community Survey. High school completion date comes from EDFacts. Disconnected youth data is from the American Community Survey, 5-year estimates. We will be looking at data from all 51 states/DC, as well as average data from the “best” 5 states as it relates to access of female reproductive health and education resources: Oregon, Vermont, Maryland, New Jersey, Hawaii, and the “worst”: South Dakota, Nebraska, Kansas, Idaho, and Tennessee from both 2016 and 2023 as identified by the Institute for Women’s Policy Research (IWPR).6 IWPR utilized a composite score system evaluating various indicators of women’s reproductive rights to identify their rankings. “The reproductive rights composite index includes nine component indicators of women’s reproductive rights: mandatory parental consent or notification laws for minors receiving abortions, waiting periods for abortions, restrictions on public funding for abortions, the percent of women living in counties with at least one abortion provider, pro-choice governors or legislatures, Medicaid expansion or state Medicaid family planning eligibility expansions, coverage of infertility treatments, same-sex marriage or second-parent adoption for individuals in a same-sex relationship, and mandatory sex education.”6 This analysis by IWPR relied on 2014 and 2015 data the Centers for Disease Control and Prevention and organizations such as the Guttmacher Institute, NARAL Pro-Choice America, and the National Center for Lesbian Rights.7 This IWPR report was utilized as it provided a viable comparison for both 2023 and 2016 reported data in County Health Rankings. The variables we will be looking at are child mortality rate, infant mortality rate, low birth weight, teen birth rate, percentage of children in poverty, percentage of children in single-parent households, and percentage of individuals who completed high school. The 2023 County Health Rankings Report is reflective of data compiled from 2017-2021. The 2016 County Health Rankings Report is reflective of data compiled from 2010-2014.
Results: We found that there is a statistically significant difference in rates of child mortality in 2016 and 2023, infant mortality in 2016 and 2023, teen birth rate in 2016 and 2023, percentage of children in poverty in 2023, percentage of children in single parent households in 2016 and 2023, percentage of disconnected youth in 2023 when comparing the top 5 and bottom 5 states with the greatest and least access to female reproductive rights. This result indicates that access to female reproductive rights and education may play a role in many different health and social factors. Further, child mortality rates, infant mortality rates, and teen birth rates in 2016 and 2023 and IWPR rankings are significantly correlated. As IWPR ranking increases (less access to female reproductive rights), rates of child mortality, infant mortality, and teen births also increase. In addition, we found that child mortality and teen birth rate had a stronger correlation with IWPR rankings in 2023 than in 2016, which could indicate that changes in reproductive policies over time might have an influence on these variables. However, the percentage of children in poverty in 2016 and 2023 and percentage of children in single parent households in 2016 and 2023 are not significantly correlated with the IWPR rankings.
In the top 5 states with the greatest access to female reproductive rights, there is a difference in the median of child mortality rates, infant mortality rates, percent children in poverty, and teen birth rates in 2016 and 2023. In the bottom 5 states with the least access to female reproductive rates, there is a difference in median of infant mortality rates, percent children in poverty, and teen birth rates in 2016 and 2023. Lastly, we found that as the teen birth rate in 2023 increases by 1%, child mortality rate in 2023 increases by 0.589%. As the percentage of disconnected youth in 2023 increases by 1%, child mortality rate in 2023 increases by 1.373%. As the IWPR rankings increase by 1%, child mortality rate in 2023 increases by 0.244%. As the percentage of children in poverty in 2023 increases by 1%, child mortality rate in 2023 increases by 1.420%. As the percent completed high school in 2023 increases by 1%, child mortality rate in 2023 increases by 1.790%.
Repository Citation
Markowski, K., & Bobko, R. (2025). An Evaluation of the Association Between Female Reproductive Health Policy and Children's Health Outcomes. Wright State University. Dayton, Ohio.
