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Summary

Structural and social determinants of health are considered fundamental causes of reproductive health outcomes, yet there is limited family planning research that integrates these measures. Additionally, while the Supreme Court Dobbs decision has drastically altered the abortion care landscape, little is known about changes in the socioeconomic characteristics and socio-contextual determinants of abortion care after Dobbs. Through spatially linking area-level data on structural and social determinants of health with individual-level clinical data on abortion care, this project aims to fill these gaps. This project will 1) develop measures of neighborhood-level structural and social determinants of health (SSDOH) for all individuals seeking abortion care at a large clinic network in Washington state, 2) explore the relationships between neighborhood-level SSDOH and type and timing of abortion care, and 3) compare changes in abortion access and care across gradients of neighborhood-level SSDOH before and after the Dobbs decision. This proposed project will contribute crucial information to the growing evidence on the impact of the Dobbs decision on abortion in the United States. The innovative approach to integrate structural and social determinants of health data with individual-level clinical data will expand our understanding of the multilevel factors influencing abortion access and care.

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