How does religious affiliation affect women's attitudes toward reproductive health policy? Implications for the Affordable Care Act

Elizabeth W Patton; Kelli Stidham Hall; Vanessa K Dalton

doi:10.1016/j.contraception.2015.02.012

How does religious affiliation affect women's attitudes toward reproductive health policy? Implications for the Affordable Care Act

Contraception. 2015 Jun;91(6):513-9. doi: 10.1016/j.contraception.2015.02.012. Epub 2015 Feb 26.

Authors

Elizabeth W Patton¹, Kelli Stidham Hall², Vanessa K Dalton³

Affiliations

¹ Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, MI 48109, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; Veterans Affairs Center for Clinical Management Research, University of Michigan, Ann Arbor, MI 48109, USA. Electronic address: pattone@umich.edu.
² Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; Institute of Social Research, University of Michigan, Ann Arbor, MI 48109, USA; Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI 48109, USA.
³ Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; Program on Women's Healthcare Effectiveness Research, University of Michigan, Ann Arbor, MI 48109, USA.

PMID: 25727764
PMCID: PMC4442032
DOI: 10.1016/j.contraception.2015.02.012

Abstract

Background: Supreme Court cases challenging the Affordable Care Act (ACA) mandate for employer-provided reproductive health care have focused on religiously based opposition to coverage. Little is known about women's perspectives on such reproductive health policies.

Study design: Data were drawn from the Women's Health Care Experiences and Preferences survey, a randomly selected, nationally representative sample of 1078 US women aged 18-55 years. We examined associations between religious affiliation and attitudes toward employer-provided insurance coverage of contraception and abortion services as well as the exclusion of religious institutions from this coverage. We used chi-square and multivariable logistic regression for analysis.

Results: Respondents self-identified as Baptist (18%), Protestant (Other Mainline, 17%), Catholic (17%), Other Christian (20%), Religious, Non-Christian (7%) or No Affiliation (21%). Religious affiliation was associated with proportions of agreement for contraception (p=.03), abortion (p<.01) and religious exclusion (p<.01) policies. In multivariable models, differences in the odds of agreement varied across religious affiliations and frequency of service attendance. For example, compared to non-affiliated women, Baptists and Other Nondenominational Christians (but not Catholics) had lower odds of agreement with employer coverage of contraception (OR 0.63, 95% CI 0.4-0.1 and OR 0.57, CI 0.4-0.9, respectively); women who attended services weekly or more than weekly had lower odds of agreement (OR 0.53, 95% CI 0.3-0.8 and OR 0.33, CI 0.2-0.6, respectively), compared to less frequent attenders.

Conclusions: Recent religiously motivated legal challenges to employer-provided reproductive health care coverage may not represent the attitudes of many religious women.

Implications: Recent challenges to the ACA contraceptive mandate appear to equate religious belief with opposition to employer-sponsored reproductive health coverage, but women's views are more complex.

Keywords: Affordable Care Act; Contraception; Policy; Religion.

Published by Elsevier Inc.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Abortion, Induced / psychology
Adolescent
Adult
Attitude to Health*
Chi-Square Distribution
Contraception / psychology
Female
Health Benefit Plans, Employee / legislation & jurisprudence*
Humans
Insurance Coverage / legislation & jurisprudence
Logistic Models
Middle Aged
Patient Protection and Affordable Care Act / legislation & jurisprudence*
Pregnancy
Religion*
Reproductive Health / legislation & jurisprudence*
United States
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding