2023 CHAS: Reproductive Health Care

Disparities persist in access to contraception

June 10, 2024

Despite the availability of counseling, disparities persist in access to contraception, especially for non-English speakers, people who are uninsured, and Coloradans of color.

Although sexual health is a key component of health care, it often isn’t centered in health conversations. The 2023 Colorado Health Access Survey included questions related to reproductive health for the first time, offering new insight into birth control trends among Coloradans. Understanding this data is important for addressing systemic barriers to accessing contraception and promoting sexual health awareness in our communities.

Birth control serves as a vital component of sexual health for many people. However, about half of respondents marked birth control-related questions as “Not Applicable.” While age, life circumstances, and other factors mean not all people require reproductive health care, this data could also reflect a lack of understanding of the topic’s importance or who it is relevant to.

Access to Birth Control Counseling and Information

The survey asked whether respondents had received counseling or information about birth control from a doctor or health care provider in the past 12 months. Among respondents who said the issue applied to them, roughly one in four said they spoke with a doctor about it. 

Different demographic groups experienced disparities in counseling access, highlighting systemic inequities that demand attention, including those based on race and gender.

Men were half as likely to get information or counseling about birth control than women. This could be the result of societal norms, gender stereotypes, and assumptions about men's reproductive health responsibilities. Addressing this disparity may require initiatives aimed at destigmatizing men's involvement in reproductive health discussions, promoting awareness among health care providers about the importance of offering comprehensive care to all people regardless of gender, and tailoring outreach efforts to better engage men in reproductive health conversations.

Black respondents were less likely to get birth control information or counseling from a doctor or health care provider compared with other racial or ethnic groups. This finding suggests that there may be systemic barriers that hinder Black Coloradans from accessing essential health care resources. These might include socioeconomic factors, cultural barriers, lack of culturally competent health care providers, or systemic racism within the health care system. Addressing this disparity is crucial for promoting equitable access to reproductive health services and ensuring that all people can make informed decisions about their reproductive health.

Use of Birth Control

People ages 18-25 reported the highest percentage of birth control use (30.9%). Usage rates decreased with age, with people ages 26-34 and 35-49 reporting lower percentages of birth control use at 24% and 14.8% respectively. This likely reflects varying life stages, relationship statuses, and reproductive intentions among different age groups. This data highlights the need for providers to offer comprehensive and age-appropriate information and resources to support people in making informed decisions about their reproductive health.

Among those who discussed birth control options with their provider, oral birth control pills (56.6%) and intrauterine devices or implants (54.6%) were the most common methods discussed.

The data also show that people who speak a language other than English were three times more likely to encounter challenges in accessing necessary birth control. Approximately 10.7% of people who speak a language other than English reported difficulty obtaining the birth control they wanted, compared to 3.3% of English speakers. Language barriers can hinder effective communication between patients and health care providers, resulting in misunderstandings, inadequate information exchange, and ultimately, restricted access to essential services like contraception.

The Big Picture

The data reveal significant disparities in access to birth control among Coloradans, with one in six people who need birth control citing barriers such as insurance coverage issues, cost concerns, and limited appointment availability. Men, Black respondents, and people who speak languages other than English are notably underserved in receiving counseling or care compared to other populations. Comprehensive reproductive health education tailored to diverse demographics is essential for addressing these disparities in Colorado. Policymakers, health care providers, and advocates must collaborate to develop and implement strategies that enhance access and make birth control more affordable.

Since 2009, the CHAS has surveyed roughly 10,000 randomly selected households every other year. The survey asks questions about one designated household member. If that person is under 18, an adult responds on their behalf.