The Abortion Map

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Will Truman

Will Truman is the Editor-in-Chief of Ordinary Times. He is also on Twitter.

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67 Responses

  1. Avatar Chris says:

    I don’t think this map allows you to draw any causal conclusions. I commented in the previous post, but a quick and dirty analysis suggests that access is the most important thing. Culture may influence access, but that’s a really difficult analysis that your map, and my small dataset, won’t allow.Report

    • Avatar Will Truman says:

      I read your comment right after posting this. It is possible that it is not about culture at all. The map doesn’t prove it is. It does suggest, to me, that it is a factor in some way.

      If it does come down to the percentage of women that live in a country with a provider, that suggests a much higher elasticity-of-demand than I would have guessed.Report

      • Avatar James Hanley says:

        Elasticity of demand tends to be higher, in general, among the poor.Report

      • Avatar Tom Van Dyke says:

        Pre- and post-Roe stats indicate that if somebody really wants an abortion, they’ll find somewhere to get one.

        http://www.tungate.com/new_page_4.htm

        Quick recap of the above: when Roe was promulgated, only 18 states still banned abortion.  In 1972—before Roe—there were still 500,000 legal abortions.  After a bump into the million-plus range in the ’80s and 90s, the link argues the number of abortions regressed to 800,000.

        Now, this doesn’t agree with other figures I’ve seen, more like 1.3 million abortions yearly.  But if the figures here are even roughly accurate, Roe only doubled the number of abortions, it didn’t send them through some exponential roof.

        My own expectation was that abortions did rise exponentially with Roe, but that simply isn’t so.  It also appears to me that the link above suggests that if Utah or South Dakota bans abortions, or if abortionists are hard to find in Jesus Christ County, U.S.A., abortionists still aren’t all that hard to find somewheres else, and getting to them physically isn’t prohibitively tough.

        Dunno if this clarifies the locality/restriction debate, but it did for me.  In reality, Jesus Christ County can use its laws to discourage abortions, and it may discourage some of them, but it won’t—can’t—prevent Maria Spermatozoa of 231 Clark St. from getting one.

        We have worked out a weird but workable way to engage this dilemma without resolving it, Athens and Jerusalem must remain in tension.  We shall never ban abortion, nor will we give it an unconditional green light.  The law can never fully embody the moral ambiguity of the human condition.  So be it.Report

        • Avatar Will Truman says:

          The regression since 1985 is interesting. Do we know what we can attribute it to?Report

          • Avatar Tod Kelly says:

            This is just a shot in the dark, but I wonder how much the growing acceptance of single mothers played into that.Report

            • Avatar Tom Van Dyke says:

              TodK may be right.  Dunno if we can know, but Bristol Palin says to me something’s sure different since pre-Roe.

              Papa Don’t Preach, Madonna 1986.  Not prophetic, not a sign of the times, but a lagging indicator.

               Report

              • Avatar BSK says:

                Bristol Palin is but one person and an outlier at that, as she was the daughter of a politician embraced by the right. The plural of anecdote is not data. When the right equally romanticizes a black girl from the city getting knocked up, I think we can better talk about real shifts.

                As a teacher, there does seem to be greater acceptance of single mothers, though that is largely reserved for mothers perceived to have the means to provide quality for their children. Teen moms are still stigmatized, though I do worry about the effects of shows like MTV’s “Teen Mom” and “16 and Pregnant”. I hope to god none of the girls on that show see getting pregnant as a cool way to get on tv and become famous. Lord knows teenagers have thought stupider things.Report

              • Avatar BSK says:

                To clarify, society rsponds very differently to the 30-year-old divorcee raising a child compared to the 40-year-old single professional adopting or undergoing sperm donation compared to the 22-year-old girl who isn’t sure who daddy is. And those situations are different and should be viewed differently. But acceptance of one situations does not mean acceptance of all. And the degree of stigma or acceptance applied often has to do with things that have nothing to do with the quality of care provided to the child, which should really be the only thing we are judging parents on.Report

              • Avatar Kimmi says:

                Yeah. Now we’ve got more videotapes.

                I don’t think the rate of sexual predation on young and innocent girls has changed much…

                And from what the Enquirer wrote (not to mention other investigators), I’m pretty convinced that was what was going on.Report

    • Avatar sonmi451 says:

      The one thing that could put culture in play is how culture influences access – in terms of what types of laws restricting abortions are passed, and how many abortion providers there are in the state. If the general “culture” of the state is to look at abortion as a bad, bad thing and something that should be made as hard as possible for women to get, I think we can see that reflected in the sort of laws passed.Report

      • Avatar Will Truman says:

        It was rather difficult to disentangle culture from laws, because the former so influences the latter. I can point to Montana, which has something of an anti-abortion culture but no restrictions, sitting next to Idaho, which has something of an anti-abortion culture and many restrictions. Idaho has a lower rate than Montana and Montana has a lower rate than average. But Montana has comparatively few providers, compared to other states.

        In other words, because of the convergence of culture, law, and access (and I would say costs of raising children), disentangling is remarkably difficult.Report

        • Avatar Jennifer says:

          In other words you mean that there’s no reason to have laws making it hard to get an abortion when you do like Montana does and just shoot enough doctors that the rest either stop providing services or leave the state.Report

          • Avatar Will Truman says:

            do like Montana does and just shoot enough doctors

            How many abortion doctors in Montana have been shot?Report

            • Avatar Jennifer says:

              Wrong question.

              The real answer is: the “Montana Freemen” send their men out to shoot people like Scott Tiller all over the nation. Often they just threaten by shooting buildings or tires, but occasionally they need to “make their point” a little more forcefully.Report

              • Avatar Jennifer says:

                Either I made my point, or you ran away. Or both. I doubt you’ve ever lived near Montana to know what it’s like. “Access” to a clinic? I doubt 90% of the state is even within 200 miles of one.Report

              • Avatar Will Truman says:

                If you’re going to say that one madman who was associated with a Montana militia killing an abortion doctor in Kansas is analogous to “like Montana does and just shoot enough doctors that the rest either stop providing services or leave the state” then I am not sure what we have to discuss. However, this…

                I doubt 90% of the state is even within 200 miles of one.

                demonstrates that I know more about Montana than you do.Report

              • Avatar Jennifer says:

                [Comment deleted 2/28/2012 as a result of confirmed sock puppetry]Report

              • Avatar Kimmi says:

                Jen,

                Ya know any docs been harrassed out of state? Gimme some numbers here, if ya don’t. It’s not that I don’t believe ya, it’s just that we TRY to put facts down around these parts.

                Ya got enough men around this blog have come from down south, I figure they know what it’s like to “run a man outta town.”

                And if they don’t, I sure as hell do. Heard about enough nasty business in Washington (and that was from One Day There! Amazin’ whatcha learn on a 90 mile busride…).

                But pony up some facts if ya can… 😉

                (It’s not just Montana. We got firsthand reports of militia’s recruiting in downtown Detroit. Heavily Recruting any white man on the street. And oy, the Militiamen down south… This country’s gotta lotta wackos. My state breeds KKK.)Report

              • Avatar Will Truman says:

                Where do you like to get coffee in Bozeman? I was a fan of the HomePage myself, may it rest in peace. I tried Rockford Coffee and like the atmosphere, but the coffee there just doesn’t taste good. Right across the street is Great Harvest Bread, where, interestingly enough, the coffee is better (but they seem to change the WiFi password to their WiFi every day and the staff doesn’t always know what the new password is, muttermutter)

                You ever eat at the Chickpea? It’s this Greek-ish place off Willson near Main. My wife is a fan of their tabouli, though I’m pretty humdrum and get the gyros. Give it a try, if you haven’t already. Tell you what place I really like: The Smiling Moose Deli. Their southwest sandwich is awesome.

                (There isn’t a Planned Parenthood in Bozeman, as far as I know. Is it new? Or just a secret?)Report

    • Avatar Mike Dwyer says:

      Chris – you keep mentioning access but I think Will asks the right question:

      “…to suggest that access is the issue is to suggest that almost 2/3 of women having abortions in New York wouldn’t be having them if it was a couple hours away. “

      Do you believe that is true? Is proximity to an abortion provider really that much of a challenge? I guess I’m asking because as somone who found myself in the same situation when I was 19, if we had chosen an abortion and a provider was several counties away I would have gotten us there come hell or high water.Report

      • Avatar Chris says:

        Mike, I don’t just believe that’s true; the data suggests that it is. As I said somewhere else on this thread, I think culture plays a role in access, but I think access is probably the biggest determinant of abortion rates, and my quick and dirty analysis backs this up.Report

        • Avatar Mike Dwyer says:

          I think you might be reaching too far on the access thing Chris. I’m not saying it isn’t a factor but I don’t think it is key metric you are presenting it to be. One of the documents you linked to says the following:

          For example, the decrease in the number of abortions in New Jersey was paralleled by an increase in the number in neighboring Pennsylvania. In 2004, some 12% of abortions among Pennsylvania residents were obtained out of state, but this proportion may have dropped in 2008.

          and…

          Changes in abortion incidence may also be due to developments within a state. For example, the abortion rate in Georgia increased 18% between 2005 and 2008. The state gained three large clinic providers (including an abortion clinic), but it lost fi ve small providers (hospitals and physicians’ offices). As a result, the proportion of women of reproductive age who lived in counties without a provider declined by five percentage points from the 62% level found in 2005, and the shift in provider types may have increased access to services and, in turn, the abortion rate.

          So we see over 10% of abortion seekers in PA willing to travel out-of-state for abortions. More importantly, there was a decrease in providers in GA and an increase in actual abortions because it was a larger provider. So it’s more nuanced than simply having a provider in close geographic proximity.Report

          • Avatar Stillwater says:

            I dunno what to make of the Penn/NJ data since it there’s no relative measure to compare it too. But the Georgia data seems to support Chris’s argument:

            As a result, the proportion of women of reproductive age who lived in counties without a provider declined by five percentage points from the 62% level found in 2005,

            By my reading, this mean means that even tho there were fewer providers, there was an increase in the percentage of women in proximity to those providers, probably because at least one of those providers was located in a high-density county. Also, one of the ‘shifts in provider types’ they’re referencing was a new clinic dedicated to providing abortion services, which seems like a relevant factor.Report

          • Avatar Chris says:

            You’ll note, Mike, that when I did the actual analysis, I used percent of women between 15 and 41 who lived in a county without an abortion provider. So your data is entirely consistent with what I’m saying: in Georgia, a decrease in that percentage of women living in counties without a provider led to an increase in abortion rates.

            The PA data isn’t relevant, I don’t think. PA, on its eastern side, is part of a tri-state area, bordering two states with a lot of providers, and two which there are easy and inexpensive transportation options. Eastern PA is about as different from, say, western Montana as it is possible for two regions to be in this regard.Report

          • Avatar Will Truman says:

            I just ran some numbers for Montana, using abortion-to-birth ratio* (ATBR) and going county by county with an eleven-year average. Even the counties within Montana that have a clinic or two don’t match New York. Missoula County, which has two providers, has a ATBR of 31.2% compared to New York’s 62.3%. Yellowstone County (Billings) also has two and a ATBR of 19.7%. Flathead County (Kalispell) is at 19.4%. Park County (Livingston) is at 16.8%.

            Missoula, Flathead, and Yellowstone are above the state average (17.3%), but Park is below it. However, Park’s clinic is likely getting its business from Gallatin County (Bozeman). Most neighboring counties are high-ish, but not statistically remarkable.

            Note, I have six of the eight clinics counted here, so I am missing two (I would guess there is one in Helena, maybe a second or third in one of the places listed). Some of the highest counties, such as Beaverhead and Madison Counties (both around 20%), do not have easy access to a clinic.

            So, looking at Montana at least, there does seem to be a correlation here, but it gives me real skepticism that but for more access, Montana would be up there with New York. Only Missoula County is above the national average.

            * – Note, I wasn’t cherry-picking on this. I picked it because those were the statistics I found.Report

            • Avatar Chris says:

              I don’t think it would be as high as New York: New York is odd. It has a super high abortion rate, and a really large number of abortion clinics (more than 200, which is significantly more than any other state). It’d probably be better to compare it to a state that doesn’t approach outlier status.Report

              • Avatar Will Truman says:

                Chris, the most abortion-heavy county in Montana, the one with two clinics (at least) and a university, is barely more than the national average. That national average that includes all sorts of anti-abortion laws that Montana doesn’t have as well as a whole lot of the population living in counties that do not have a clinic.

                I compared it to New York because that’s the conversation we were having (New York vs Montana), not because I needed it to be New York for Montana to be low.Report

              • Avatar Chris says:

                I don’t mean to imply that there’s nothing to your analysis. Increased access is highly correlated with increased rates. There’s no doubting that. It implies, though causality is tricky with these things, that an increase in abortion clinics would increase rates. Would they increase at the same rate in all states? No. In New York, we’ve probably reached a point of diminishing returns. In Montana, the increase will be dampened by regulation and, in all likelihood, culture.

                And don’t forget, stigma is part of culture.

                Looking at Montana’s data more closely, it’s a fairly uninteresting case. It’s abortion rate per 1000 women (I think this is probably a better stat to use) is just below the national average (12 vs 13.5), it’s % of women in counties without providers is just above the national average (49% vs 44.1%), it didn’t have a waiting period law in 2008 (the year of the other numbers), and in 2008 it was possible to use medicaid or private insurance to fund an abortion. So, on the whole, Montana appears to have average to slightly better than average access (if we include provider access and legal restrictions) and a slightly below average abortion rate. I’m not sure it tells us much, and comparisons with New York are probably unproductive. If we want to look at the influence of culture, there’s only a little room for it to explain Montana, but access doesn’t explain everything about Montana.Report

              • Avatar Will Truman says:

                Chris,

                I’m not sure where you’re getting the 12/13.5 from.I’m looking at 12.3 vs 19.6 per women of reproductive age. I don’t have a problem using that statistic. If anything, it accentuates the difference (12.3/19.6 vs 13/19). If I’d used that statistic, the differences would have been more stark, but I figured if I used it that, I’d get (fair) complaints about interstate abortions skewing the results.

                I believe Montana to be an instructive case because it’s one of the states perceived as conservative where you can’t hang your hat on the fact that it’s all about anti-abortion law. A great many of the other low-population, conservative-ish states (The Dakotas, Wyoming, Idaho, and Utah) all have laws that complicate things.

                None of this is to say that abortion rates wouldn’t increase with providers. We agree on that. The question is how much. How much is the number of providers a reflection of need, and how much of demand is a reflection of supply. Your analysis has me thinking that it’s more the latter than I would have guessed. But I think I am less dismissive of the culture argument than you are.Report

              • Avatar Chris says:

                Will, I got my stats from Kaiser, and it’s only for the year 2008. I linked it in the other thread.Report

              • Avatar Will Truman says:

                I’m not sure why there would be such a significant disagreement between Kaiser and Guttmacher. I looked through your links yesterday and found a Kaiser link that put Montana at 12 (which is about the same as Guttmacher), but didn’t see the 13.5 number.Report

      • Avatar James Hanley says:

        Mike,

        If you think it’s wrong, you need to deal with Chris’s statistical analysis.  Statistics don’t always tell us the whole story, but they do need to be addressed.  Remember that the data he used was “percent of women in counties with no provider.”  If that shows a difference, then it means that proximity to provider does matter.

        It doesn’t matter matter how certain any of us are that we would act differently, because the data takes into account those that do travel across county lines for an abortion. It doesn’t say that nobody does that, and there could even be lots of people doing that.  But among those who don’t have an abortion, lots of them are those that are deterred by travel.  It’s important to keep in mind that we’re talking about averages here, and averages are made up of individuals that differ, so finding someone non-average is generally about the easiest thing in the world.

        Keep in mind also that for many young women the choice to have an abortion is not an easy one.  Because of their uncertainty, the relative ease of obtaining one may be the, or at least a, factor that tips the balance.

         Report

  2. Avatar Snarky McSnarkSnark says:

    Looks like this is abortion week…Report

  3. Avatar Chris says:

    My point is simply that we can’t finger culture, and we certainly can’t finger any aspect of culture, for any magnitude of the difference. Obviously, given voting patterns, conservative states produce more regulations and fewer providers, and this is partially due to culture. On the other hand, with more providers, it’s almost certain that the rates would go up, even in conservative states.Report

    • Avatar Mike Dwyer says:

      Chris – let me try hitting the culture argument from a different angle…

      In my post I talked about public funding for contraception. I think it’s hard to argue that the money spent is NOT a product of cultural attitudes expressed through the political process. It’s maybe not red vs. blue. It might be priority setting in poor states and something has to give. Either way, it reflects what people think is important.

      With that in mind, wouldn’t the presence of more or less abortion providers also reflect cultural attitudes i.e. more demand? I mean, I assume these clinics are not opened with the intention of creating demand. They must see a demand there. So the question is whether or not a new clinic in a previously under-served area in any state is going to receive roughly the same amount of new business, or if that will differ from state to state depending on attitudes there. Report

  4. Avatar choice says:

    Different states may have differential rates of use of Plan B or availability of Plan B.  There may be a difference in costs of reliable forms of birth control.  There may also be a difference based on some people leaving one state and going to another for an abortion.  For example, late term abortions are more available in NY than some neighboring states, so if your life is threatened by your pregnancy at six months, you might prefer to go there just because you are likely to find a doctor better able to perform the procedure.  Practical considerations like this make it difficult to speculate on the map.  However, it is true that there are great cultural differences.  New Yorkers saw Mississippians as virtually uncivilized about the issue of abortion until the vote last fall against the “personhood” bill there.  A study of the earlier, pre-Roe v Wade laws in different states would reveal how different the states were.  Some state laws were very liberal (NY), others fairly liberal (Illinois), and still others shockingly strict (Texas).Report

    • Avatar Will Truman says:

      Interstate abortions are accounted for in the above map. It tracks pregnancies by state. I do make references to the ARPWORA metric, which looks only at where they are performed. But the map is not based on that.

      State laws wouldn’t be a bad metric, though some states have really shifted since RvW.Report

    • Avatar JG New says:

      “New Yorkers saw Mississippians as virtually uncivilized about the issue of abortion until the vote last fall against the “personhood” bill there.”

      It’s not the abortions, it’s the banjos.Report

  5. Avatar Dan Miller says:

    Thanks for the work.  This whole debate, though, illustrates to me the fundamental perniciousness of states.  They’re pretty much completely arbitrary, and have no functional connection to lived experience, and yet a ton of data and policy is collected and acted upon at the state level.  A person living in Chicago has a lot more common interests with a person in northwest Indiana than they do with a person from downstate, but the latter two are lumped together while the first two are treated as completely independent.  If it were up to me, state governments would be deprecated as much as possible and much more would be done at at the metro-area level.Report

    • Avatar Michael Cain says:

      One statistic I occasionally find useful with is the Census Bureau’s measure of “percent rural population” in a state, where rural used to be defined something like living more than 25 miles from a population center with at least 25,000 people.  They mess with it from time to time, so  All of California, Nevada, New York, and New Jersey, for example, have quite low percent rural population.  South Carolina’s figure is much lower than Georgia’s, despite any other perceptions of cultural similarities.  It’s clearly not the only factor, but some aspects of life in rural areas may have an impact: lack of anonymity, distance from providers, poverty, etc.Report

      • Avatar Michael Cain says:

        Geez, what a set of fumble fingers!  South Carolina’s “percent rural population” is higher than Georgia’s, which may explain their lower termination rate.  Kentucky is significantly more rural than Tennessee; Mississippi than Alabama.  I’ll have to play with some statistics…Report

      • Avatar Will Truman says:

        I think you might be on to something with rurality and lack of anonymity being a factor.Report

  6. Avatar Pierre Corneille says:

    but to suggest that access is the issue is to suggest that almost 2/3 of women having abortions in New York wouldn’t be having them if it was a couple hours away.

    I imagine a two-hours’ distance is quite a lot, especially for poorer and teenage women.  It’s hard to rent a car until one is, say, 23 or 25, and unless one has a credit card.  Or if one goes greyhound, one would need to probably go the day before the appointment and find a motel room or someone in that town to stay with (after all, greyhound is usually not that reliable, a ride two hours by car on greyhound can last up to four hours, assuming the bus leaves on time).  Add to this that it’s my understanding that clinics and hospitals do not allow patients to leave if there’s no one to see them home safely, so it’s necessary to find someone else, too.

    I imagine the issue changes with age, and culture, as you say, plays a role (probably).  I’m just saying that two hours’ distance might be a lot for some people.Report

    • Avatar Chris says:

      I live in Texas. Two hours is across the street.Report

      • Avatar wardsmith says:

        In New York City, two hours travel time could be one island over. It ain’t always distance.Report

        • I don’t know New York City.  And if that’s what’s meant by “2 hours away,” then I might be wrong.  However, when someone says something is “2 hours away,” I usually think “about 120 miles away.”  For example, from where I live in Chicago, it takes about 1 hour to get to Evanston by public transportation, but I would not say that Evanston is “1 hour away.”  The distance, I think, is probably no greater than 10 miles.  On the other hand, when I lived in Denver, I would think of Fort Collins as about 2 hours away, even if it took me an extra half-hour to get out of the Denver city limits because of rush hour traffic.  (Disclosure: I didn’t make the drive enough to know whether it took that long to get out of Denver, and I suspect most people can get to Ft. Collins more quickly than 2 hours.)

          Again, though, I don’t know New York City, and if people say “2 hours” to mean a distance that’s much shorter than 120 miles, then that’s not what I was referring to.Report

  7. Avatar Plinko says:

    I said this in my initial reaction to the Trivia thread – the most obvious explanation at first glance for the odd state contrasts is probably the presence of a large metro area. Why is South Carolina 9% and Georgia 18%? Why is Wisconsin 9% and Illinois 20%? That speaks heavily to both cultural AND access reasons (of course, how do we separate access from culture?).

    The large metro area speaks to all factors anyone has pointed to – more access, more Democratic, more affluence, higher cost of raising a child.

    One would need to do some more advanced regression to account for those factors before making any broad statement of explanation, does the ‘blue’ness or the accessibility give us a better read on all states than other factors?

    Recognizing what Mike was trying to do in his post – the big lacking data point to compare is actual contraceptive use – maybe New York and Florida have lower usage rates – to pregnancy and abortion rates.Report

  8. I’m wondering if ease of access puts less of a psychological stigma on the decision to have an abortion – that is to say, if my particular locality is full of abortion providers, then it must be okay, but if I have to drive hours and hours away to get an abortion, it introduces an aspect of the forbidden.Report

  9. Avatar Sam says:

    When we’re throwing this term “culture” around, we’re doing strictly in the sense that some culture is tolerant of women with unwanted pregnancies terminating and that some culture is intolerant of women with unwanted pregnancies terminating, right? We’re not then leaping to judgements from there, are we?Report

    • Avatar Will Truman says:

      Treatment of how one deals with an unwanted pregnancy is certainly a part of it, as are any obstacles and lack of assistance. Not necessarily all of it. Some of it could be related to what young women are taught about abortion and the morality thereof.

      If you choose to believe that all of culture comes down to this, and that there are none or only a trivial number of women who internalize a value system in which abortion is condemned, I certainly cannot prove otherwise.

       Report

      • Avatar Sam says:

        The argument seems to be that culture is playing a role in the lower abortion rates in certain places. What I’m asking is whether we’re taking an expansive view of culture or if we’re taking one limited to this one particular topic. Are we simply saying, in other words, that the culture in places with lower abortion rates reflects a higher valuation of pregnancy, or are we expanding that claim beyond the issue of abortion, to say perhaps more broadly that life is more valued in places with lower abortion rates?Report

  10. Avatar Citizen says:

    There is probably some “Casanova” factor missing from the discussion. A males ability to persuade females to copulate may be different in New York than in Wyoming. Women can also be very culturally different from one location to the next.

    To analyze why people do the things they do often requires the abandonment of logic and reason.Report

    • Avatar Kimmi says:

      *nods* yes of course. many sexual predators would find a rightwing church a wonderful haven. naturally, they’re also the sort of folk against abortion…Report

      • Avatar Citizen says:

        The highest rate of abortion per capita that I can recall involved a high school. A new handsome coach started his job and soon after most of the girls basketball team became pregnant.

        The number or proximity to abortion clinics was not much issue. The wealth/religion of the people involved didn’t appear to be a factor. 

        I propose if the coach had the “Casanova” appeal of Hank Hill, the results would have varied.

        http://en.wikipedia.org/wiki/Hank_Hill

         Report