The impact of housing insecurity on access to abortion: Perspectives of patients and providers in the Bronx
Awarded 2021
Complex Family Planning Fellowship Research
Rithika Mathias, MD
Albert Einstein College of Medicine

Housing insecurity continues to be a pervasive issue throughout the United States, with numbers projected to increase due to the Covid-19 pandemic. Families in particular continue to be a growing segment of the homeless population. In New York City women are the “head of the household” in ninety-three percent of homeless families. Research shows homeless populations have decreased access to all healthcare including reproductive healthcare. This leads to disparities in both preventative services including pap smear, contraceptive and prenatal care utilization, as well as, worse pregnancy outcomes including increased rates of preterm birth, and low birth weight infants. Minimal research though is done on abortion outcomes for this population. A recent study from UCSF showed people who are housing insecure present later to abortion care leading to increased abortion complications. Since we do not have a good understanding for the delay in accessing abortions, we will explore the impact housing insecurity has on access to abortion care in the Bronx by using qualitative methodology. We will work with two homeless healthcare organizations and interview both providers who care for housing insecure individuals within family, domestic violence and single adult shelters, as well as, the patients who access care there. After analysis of our data, we will work with the providers we interviewed to better streamline their abortion services. As more families with women as the designated “head of household” lose stable housing, it is important to ensure that they have access to all the medical care and services they need, including timely abortion.