Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies

Abstract

Objectives

Race differences in contraceptive use and in geographic access to pharmacies are well established. We explore race differences in characteristics of nearby pharmacies that are likely to facilitate (or not) contraceptive purchase.

Study Design

We conducted analyses with two geocode-linked datasets: (1) the Relationship Dynamics and Social Life (RDSL) project, a study of a random sample of 1003 women ages 18–19 living in a county in Michigan in 2008–09; and (2) the Community Pharmacy Survey, which collected data on 82 pharmacies in the county in which the RDSL study was conducted.

Results

Although young African-American women tend to live closer to pharmacies than their white counterparts (1.2 miles to the nearest pharmacy for African Americans vs. 2.1 miles for whites), those pharmacies tend to be independent pharmacies (59 vs. 16%) that are open fewer hours per week (64.6 vs. 77.8) and have fewer female pharmacists (17 vs. 50%), fewer patient brochures on contraception (2 vs. 5%), more difficult access to condoms (49% vs. 85% on the shelf instead of behind glass, behind the counter, or not available), and fewer self-check-out options (3 vs. 9%). More African-American than white women live near African-American pharmacists (8 vs. 3%). These race differences are regardless of poverty, measured by the receipt of public assistance.

Conclusions

Relative to white women, African-American women may face a “contraception desert,” wherein they live nearer to pharmacies, but those pharmacies have characteristics that may impede the purchase of contraception.

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Notes

  1. 1.

    Thus, one limitation of the Community Pharmacy Survey is that these characteristics of pharmacy staff are measured with a higher degree of error than the other, directly observable characteristics of the pharmacy. We discuss this further in the “Limitations” section. Chi-square tests indicate no differences in pharmacy characteristics between the surveyed and the observed pharmacies (not shown in tables).

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Acknowledgments

The authors gratefully acknowledge the Survey Research Operations (SRO) unit at the Survey Research Center of the Institute for Social Research for their help with the data collection, particularly Vivienne Outlaw, Sharon Parker, and Meg Stephenson. The authors also gratefully acknowledge the intellectual contributions of the other members of the original RDSL project team, William Axinn, Mick Couper, and Steven Heeringa, as well as the Advisory Committee for the project: Larry Bumpass, Elizabeth Cooksey, Kathie Harris, and Linda Waite.

Funding Statement

This research was supported by three grants from the National Institute of Child Health and Human Development (R01 HD050329, R01 HD050329-S1, U54 HD093540), a grant from the National Institute on Drug Abuse (R21 DA024186), and a population center grant (R24 HD041028) and training grant (T32HD007339) from the National Institute of Child Health and Human Development to the University of Michigan’s Population Studies Center. Funders did not participate in data collection or analysis or the writing of this manuscript.

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Correspondence to Jennifer S. Barber.

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Appendix

Appendix

Table 5 Comparison of characteristics of pharmacies within five miles, by race and poverty, Relationship Dynamics and Social Life (RDSL) study, Michigan, 2008–2009 (n = 961 women, except where noted)
Table 6 Comparison of characteristics of nearest pharmacy, by race and receipt of public assistance, Relationship Dynamics and Social Life (RDSL) study, Michigan, 2008–2009 (n = 961 women, except where noted)

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Barber, J.S., Ela, E., Gatny, H. et al. Contraceptive Desert? Black-White Differences in Characteristics of Nearby Pharmacies. J. Racial and Ethnic Health Disparities 6, 719–732 (2019). https://doi.org/10.1007/s40615-019-00570-3

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Keywords

  • Pharmacy
  • Race differences
  • Contraceptive use
  • Access to pharmacies