Drivetime to Assisted Reproductive Technology Clinics in the US: Urbanization and Sociodemographic Patterns

Abstract:

Utilization of infertility care in the United States is highly stratified and misaligned with the prevalence of infertility. One potential mechanism of this inequality is geographic access to care, especially as geographic distance to care has been associated with utilization and discontinuation of care. The present study utilizes geographic locations of all main ART clinics in the United States in 2021 and population counts from the American Community Survey to investigate the drive-time distance to ART clinics overall and by sociodemographic groups. Building on previous work, this study also assesses the role of urbanicity on geographic access to care. The results show that nearly 42% of women are more than 30-minutes from an ART clinic, and uncovers considerable variation by sociodemographic groups within and across urbanicity. Taken together, the findings imply that for some well-documented inequalities in ART utilization, geographic barriers are unlikely to explain differential utilization.

Keywords: health, GIS, race

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