Natural and social disasters: Racial inequality in access to contraceptives after hurricane ike

Background: Few data are available on access to contraception following a natural disaster. The current study extends the literature by examining access to various types of birth control in a large sample of women from diverse backgrounds following Hurricane Ike, which made landfall on September 13, 2008, on the upper Texas Gulf Coast. Methods: We examined Hurricane Ike's influence on access to contraceptives through survey results from 975 white, black, and Hispanic women 16-24 years of age receiving care at one of five publicly funded reproductive health clinics in the Texas Gulf Coast region between August 2008 and July 2010. Results: Overall, 13% of women reported difficulties accessing contraception. Black women had more difficulty than their white (p<0.001) and Hispanic (p=0.019) counterparts. Using multivariate analysis, we found that although family planning clinics in the area were open, black women (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.37-3.73; p=0.001] and hurricane evacuees (OR 2.17, 95% CI 1.27-3.72; p=0.005) reported greater difficulty in accessing birth control. Last, we found that a lack of access to birth control was related to having a higher frequency of unprotected sex for women of all races (p=0.001). Conclusions: Access to resources is critical in differentiating the level of impact of disasters on various groups of people. We suggest a community-based disaster preparedness and response model that takes women's reproductive needs into account.