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National Survey Shows People in Arizona, Iowa and Wisconsin Experiencing Financial Hardship Were Especially Hard Hit

The COVID-19 pandemic has prevented or delayed more than half of family planning patients in Arizona from getting birth control or related sexual and reproductive health care—and those who experienced financial hardship were particularly affected—according to a new Guttmacher Institute study.

The study—conducted between May 2020 and May 2021— examined access to contraceptives and other sexual and reproductive health care among almost 1,500 patients at Title X publicly funded clinics that provide sexual and reproductive healthcare services in Arizona, Iowa and Wisconsin.

The study found that 57% of family planning patients in Arizona, 38% in Iowa and 30% in Wisconsin faced delays in, or barriers to, obtaining birth control or related care. In addition, Arizona patients who experienced financial hardship were likely to have fewer resources and financial support to mitigate the economic fallout of the pandemic. Such patients had higher odds of experiencing delays or barriers than those who did not, three times higher in Arizona and six times higher in Wisconsin.

 “The COVID-19 crisis has curtailed access to contraceptives and other sexual and reproductive health care in states nationwide—particularly for people who were hard hit by the pandemic’s negative financial and employment effects—and our study documents these impacts in three states,” said Megan Kavanaugh, principal research scientist at the Guttmacher Institute. “This has deep and far-reaching impacts for people who need and deserve access to high-quality, affordable birth control and other care so they can make the fundamental choice about if and when they want to be pregnant and have children.”

In Arizona, nearly 75% of respondents received care at a health care center receiving Title X grant support for services.

 “Even in the face of these distressing numbers, it is important to emphasize that without Title X services at health care centers across the state, even more individuals would have found themselves without critical and appropriate sexual and reproductive health care,” said Bré Thomas, CEO at the Arizona Family Health Partnership which provides funding for Title X services at health centers in 11 Arizona counties. “Title X services and programs remain a vital resource for low-income individuals in Arizona.”

COVID-19 is making health disparities worse

This three-state study followed two Guttmacher national surveys, conducted in 2020 and 2021, that found the pandemic had widespread impacts on respondents’ ability to get birth control and related care. The severity of those impacts lessened during the course of the pandemic, but the effects were still present in 2021, when 19% of respondents said they had trouble getting their contraceptives or other sexual and reproductive care.

The two national surveys also found that COVID-19 continues to have a disproportionate impact on those already marginalized as a result of their race, income or sexual orientation.

Guttmacher’s new state study echoes these findings, demonstrating the ongoing challenges of the pandemic at the state level.

“The COVID-19 pandemic disproportionately affects the sexual and reproductive health of people of color and those who are LGBTQ, have lower income or are facing financial and employment difficulties,” Dr. Kavanaugh said. “Addressing these inequities is crucial to ensuring that all people can decide when, whether and how to become parents, and have the support they need to take care of their families.”

The new three-state study is part of the Reproductive Health Impact Study, a multiyear comprehensive research initiative that analyzes the effects of federal and state policy changes—including the restrictions the Trump-Pence administration imposed on the Title X national family planning program—on publicly funded family planning care in Arizona, Iowa, New Jersey and Wisconsin. More findings from this project will be released later this year.

“State and federal policymakers must take steps to expand and support access to the full range of sexual and reproductive health care, especially for individuals who experience the greatest barriers to care,” Dr. Kavanaugh added. “Policymakers should also support efforts to expand access to sexual and reproductive care in innovative ways and through a diversity of options—from in-person care to telehealth—with particular attention to the needs of individuals with fewer resources.”

The nationwide federal Title X grant program, created in 1970 and administered by the U.S. Department of Health and Human Services, Office of Population Affairs (OPA), prioritizes serving people and families with low-incomes and is implemented through grants to over 3,500 clinical sites, including public health departments and non-profit health centers.

For more information about Arizona Family Health Partnership, visit AFHP also owns and operates® offering complete, medically-based information about contraceptive methods and adolescent rights as well as a health center locator.® allows clients to easily connect to care.

For more information about the Guttmacher Institute, visit