Take control

1. Take control Birth Control Options Lead to Healthy Communities

2. THE ISSUE • Lack of access to birth control options leads to negative social economic and health outcomes • Unintended pregnancies and unintended births are one of the main consequences • Low income women and teenage women have the highest rates of unintended pregnancies • This creates reproductive disparities within lower income groups

3. CONSEQUENCE OF UNINTENDED PREGNANCY • Unintended Pregnancies increase the rates of: • Abortion • In 2006 43% of unintended pregnancies ended in abortion • Teenage Pregnancy • 4 out of 5 unintended pregnancies occurred with women aged 19 and under. • Economic Strain • Both the individuals and the public at large feel this strain • In 2006 64% of unplanned births were publically funded resulting in approximately 11.1 billion dollars • Of these, only 33% of these families were eligible for Medicaid funding.

4. CONSEQUENCE OF UNINTENDED PREGNANCY • Poor Health Outcomes • Women who have unintended births have a higher risk of depression • Unintended pregnancies can lead to delays in pre-natal care, which can cause increased risk for pre-term birth and birth defects • Poor Social Outcomes • Women who have unintended pregnancies have greater relationship instability • Strain between mothers and children can intensify in the case of unwanted birth

5. WHY COOK COUNTY? Cook County Births by the Numbers (2003) Race/Ethnicity 65.2 % White 29.0 % Black 32.0 % Hispanic Marital Status 58.3% Married 41.7% Single Education (Mothers) 27.1% No HS Diploma Prenatal Care 81.3% 1st Trimester 4.3% 3rd Trimester/No Care Age 70.4% 20 yrs. or younger • Cook County has one of the highest rates of teen pregnancy in the country. • In 2010 Cook County accounted for approximately 62% of abortions statewide. • High rates of health disparities within the county result in a greater number of high risk individuals

6. BEHIND THE DISPARITIES • Lack of Health Coverage • 16.4% Cook County residents lack health coverage • Of this, 44% represent women • Birth control is expensive • With insurance coverage out of pocket costs can range between $15- $960 annually • Without insurance cost can range between $590- $1200 annually

7. BEHIND THE DISPARITIES • Lack of education • Many women have inaccurate beliefs regarding pregnancy and contraception including: • Lack of knowledge of birth control options • Belief in myths such as a perceived inability to get pregnant during first instance of sexual intercourse • Cultural beliefs • High religious involvement low income areas may decrease the number of individuals who use contraception. • Distrust of medical establishment common in minority communities lends reduced use of birth control

8. THE SOLUTION • INCREASE ACCESS • Increase funding to Title X programs • Obtain funding to provide high risk communities free condoms and birth control pills • Obtain funding to expand coverage for all types of contraception • Create sliding scale payment systems for uninsured women when receiving • Increase number of practitioners and clinics in high risk communities • Work with Cook County employers to encourage enforcement of Affordable Care Act contraception mandate

9. THE SOLUTION • EDUCATION • Provide education about contraception through community outreach in affected communities • Inform community about different methods of contraception • Educates women on whichmethods would work best for them • Provide information on how to use chosen each method • Address myths and cultural beliefs specific to each community affected • Increase comprehensive sex education classes for children and adults

10. BENEFITS • Ensures that Cook County women are educated about sex and their contraception options • Reduces rates of abortion • Helps to ease distrust that may exist between medical and minority communities • Provides greater support to women who are seeking contraception • Empowers Cook County women to take control of their reproductive health

11. WHAT IS BEING DONE? • Currently there are several initiatives that are working toward this goal • Affordable Care Act • Provides health coverage for millions of uninsured Americans • Contraception Mandate requires that all health insurance plans provide coverage for all contraceptives approved by the FDA • Does not cover individuals who do not have health insurance • Exemptions for employees of religious institutions exist • Healthy People 2020 • Continues toward goal of improving family planning and reducing unintended pregnancies • Requires diligence to ensure these services are provided as required by Cook County

12. WHAT IS BEING DONE? • Title X Funding • Federal grant program dedicated solely to family planning and preventive services • In 2008, 108 Family Planning Centers in Illinois were utilizing Title X funding, aiding over 130,00 Illinois women • However, in the same year there were over 700,000 women in need of such services • HB2675 • Enhances sex education in grades 6-12 to include abstinence as well as contraception education for any sexual education program • Allows for exemptions for school districts as well as individual famiies

13. POLICY PARAMOURS • Toni Preckwinkle • Cook County Board President • Oversees the Cook County Commission on Women’s Issues • Peggy A. Montes • Chairwomen of Commission on Women’s Issues

14. POLICY PARAMOURS • William Davis • IL State Representative serving constituents in Cook County IL • Chairman of the Committee of Health and Health Care Disparities • Mattie Hunter • IL State Senator serving constituents in Cook County IL • Member of the Public Health Committee; Chairman of subcommittee on Special Issues in Public Health

15. STAKEHOLDERS- GOVERNMENTAL • Cook County Commission on Women’s Health • Cook County Department of Public Health • Illinois Department of Public Heath • Department of Health and Human Services Family Planning Services • Illinois House of Representatives Committee of Health and Health Care Disparities • Illinois State Senate Public Health Committee • Healthy People 2020 • Chicago Public Schools

16. STAKEHOLDERS- NONGOVERNMENTAL • Planned Parenthood • NARAL Pro-Choice America • Illinois Healthy Women • American College of Obstetricians and Gynecologists • Guttmacher Institute • Mikva Challenge • Illinois Caucus for Adolescent Health • Religious Coalition for Reproductive Choice • Chicago Women’s Health Center • The Women’s Health Foundation

17. REFERENCES • Finer, L.B. & Zolna, M.R. (2011). Unintended Pregnancy in the United States: incidence and disparities: 2006. Contraception, 84(5), 475-485. Retrieved from: http://www.guttmacher.org/pubs/journals/j.contraception.2011.07.13.pdf • Guttmacher Institute. (2012). In Brief: Facts on Unintended Pregnancy in the United States. Retrieved from: http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html • The National Campaign. Unplanned Pregnancy: The Consequences of Unplanned Pregnancy. Retrieved from: http://www.thenationalcampaign.org/resources/pdf/FactSheet-Consequences.pdf • Barber, J.S., Axinn, W.G. & Thornton, A. (1999) Unwanted childbearing, health, and mother-child relationships. Journal of Health and Social Behavior, 40(3), 231-257. • Mayer JP. (1997). Unintended childbearing, maternal beliefs, and delay of prenatal care. Birth, 24(4):247–252. • Planned Parenthood (21 Sept 2011). New Planned Parenthood of Illinois Wicker Park Health Center Unveiled. Retrieved from: http://www.plannedparenthood.org/about-us/newsroom/local-press-releases/new-planned-parenthood-illinois-wicker-park-health-center-unveiled-37913.htm • Illinois General Assembly. (19 Jun 2012). Bill Status of HB2675.Retrieved from http://www.ilga.gov/legislation/BillStatus.asp?DocNum=2675&GAID=12&DocTypeID=HB&SessionID=85&GA=98 • Illinois Department of Public Health. (2010) Health Statistics: 2010 Illinois Abortion Statistics. Retrieved from: http://www.idph.state.il.us/health/abortion/abort10.htm • Illinois Department of Public Health. (My 2008) Vital Statistics Illinois 2003: Selected Natality Statistics Among Residents of Cook County. Retrieved from: http://www.idph.state.il.us/pdf/2003_Vital_Statistics_Illinois.pdf#page=113 • Becker, S. (23 October 2012). Landscape of Illinois’ Uninsured and Underinsured: What Do We Know and What Do We Need to Know Before 2014? Illinois Health Matters. Retrieved from: http://illinoishealthmatters.org/wp-content/uploads/2012/10/Slides-for-EnrollAmerica.October23.FINAL_-21.pdf • Thorburn Bird, S., Bogart, LM. (2003). Birth Control Conspiracy Beliefs, Perceived Discrimination, and Contraception among African Americans: An Exploratory Study. Journal of Health Psychology, 8(2):263-76.

18. REFERENCES • Sebelius, K. (20 Jan 2012). A Statement By U.S. Department of Health and Human Services Secretary Kathleen Sebelius. Retrieved from: http://www.hhs.gov/news/press/2012pres/01/20120120a.html • Healthy People 2020. (2010). Family Planning. Retrieved from: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=13 • Guttmacher Institute. (2011). State Facts about Title X and Family Planning: Illinois. Retrieved from: http://www.guttmacher.org/statecenter/title-X/IL.html • U.S Department of Health and Human Services: Office of Population Affairs. (2013). Title X Family Planning. Retrieved from: http://www.hhs.gov/opa/title-x-family-planning/index.html • Cook County, Illinois. Women’s Issues, Commission on. (2013). Retrieved from: http://www.cookcountygov.com/portal/server.pt/community/women%E2%80%99s_issues,_commission_on/297 • Illinois General Assembly: 98th General Assembly. (2013). Subcommittee on Special Issues (PH). Retrieved from: http://www.ilga.gov/senate/committees/members.asp?CommitteeID=1471 • Illinois General Assembly: 98th General Assembly. (2013). Health & Healthcare Disparities Committee. Retrieved from: http://www.ilga.gov/house/committees/members.asp?CommitteeID=1230&GA=98