The Impact of Family Planning Funding Cuts on Preventive Care

Abstract

Many women rely on family planning and women’s health organizations as their only recent source of care, including preventive care. Recently, several states have cut public funding for women’s health organizations that are associated with abortion services. This paper is the first to quantify the impact of these funding cuts and resulting clinic closures on the incidence of preventive care, focusing on Texas and Wisconsin during the 2007-2012 period. Using quarterly data on health center street addresses from a national network of women’s health centers and confidential respondent ZIP codes from the Behavioral Risk Factor Surveillance System (BRFSS), we calculate changes in distance to the nearest clinic over time. From a within-ZIP-code analysis, we conclude that an increase of 100 miles to the nearest clinic would result in a decrease in the annual utilization rate of a clinical breast exam by 6 percentage points (pp), a mammogram by 2 pp, and a Pap test by 9 pp. These estimates are generally larger for low-education women: 14 pp, 6 pp, and 8 pp respectively. Future analysis will incorporate 2014 survey data to cover a more recent round of cuts.

Keywords: Women’s health care, preventive health care, clinic closure, access to care, public finance, abortion, cancer screening

JEL Classification: H75, I18, J13