Using Data to Measure Reproductive Freedom

• The National Institute for Reproductive Health created the “Local Reproductive Freedom Index” to score cities on the strength of their women’s health services and policies such as paid family leave and sexually transmitted infection prevention campaigns

• Cities can use the City Health Dashboard to show the impact that policy has on women's health

• Cities with strong reproductive freedom policies tend to have better prenatal care and lower rate of teen births

In the public health field, we traditionally rely on data to measure how well we are doing to improve people’s health. Linking data to policy and vice versa, helps cities see the need for policies that advance reproductive freedom in their community and to demonstrate the impact of the policies they have already passed. This can be difficult on the city level, where data is often hard to find, making the City Health Dashboard a valuable and exciting resource.

The National Institute for Reproductive Health (NIRH), where Jenny works, focuses on reproductive health public policy and advocacy at the state and local levels. Jenny spearheaded the Local Reproductive Freedom Index (Local Index), a first of its kind report, to evaluate the reproductive health, rights, and justice policies of 40 U.S. cities. The Local Index assigns cities a score from 0 to 5 stars based on the number and strength of their reproductive freedom policies, including paid family leave, STI prevention funding, and anti-discrimination policies.

City leaders can pair their Local Index score with local level-data to see the type of impact policies have on women’s health. When we used the Dashboard’s data, we found that cities with higher Local Index scores were associated with lower rates of teen births.^1,2,3

Cities with higher Local Index scores also had higher percentages of women receiving prenatal care during pregnancy.³

While there are other factors influencing low teen birth rates and prenatal care, cities with strong policies like paid family leave and funding for family planning frequently also have higher reproductive freedom. 

Cities and organizations, like NIRH, can use the Dashboard’s data to enhance their interventions and shape policy at the local, state, and federal levels.

Take Action

1. Explore your city’s teen births and prenatal care data.

2. Read NIRH’s Local Reproductive Freedom Index report in full, and join their mailing list to receive the 2nd edition of the Local Index, coming in Fall 2019.

3. Check out the Dashboard’s existing evidence-based resources for teen births and prenatal care.

4. Reach out to the Dashboard about new metrics that would be helpful in understanding your city’s health and health-related policies. We are always interested in collaborating!

Jenny Dodson Mistry, MPH, is the Senior Manager of Special Initiatives at National Institute for Reproductive Health. Allegra Wilson is a Research Analyst on the City Health Dashboard.

Learning More

¹ For more information on NIRH’s approach to pregnant and parenting youth, see Young Women United’s 2016 report, Dismantling Teen Pregnancy Prevention.

² Estimates of county- and city-level teen births and prenatal care are from 2014-2016 Natality Data from the National Vital Statistics System of the National Center for Health Statistics. Because the analyses required restricted data, they were accessed through the Research Data Center. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the Research Data Center, the National Center for Health Statistics, or the Centers for Disease Control and Prevention.

³ A sensitivity analysis was also conducted. The subset cities was restricted further to only cities with estimates of teen births and prenatal care calculated from city-specific values (county_indicator=0). Cities with estimates from an average of component counties’ values (county_indicator=1) and estimates from a single corresponding county value (county_indicator=2) were excluded. Teen births had 37 cities with estimates and prenatal care had 30 cities with estimates after the sensitivity analysis. The correlations were still statistically significant for teen births (r=-0.56, p<0.05) and prenatal care (r=0.53, p<0.05).

Last updated: June 4th, 2019