Ensuring Access to Education and Services on Infertility for the Underserved

In 1982, 8.4 percent of all currently married American couples had childbearing impairments for reasons other than surgical sterilization (Mosher and Pratt, 1985). This suggests that more than 2.5 million couples were candidates for infertility services, that is, medical advice and assistance in conceiving or successfully carrying a baby to term. Some couples with nonsurgical childbearing impairments, however, may not seek infertility services because they have no desire for children (or for additional children) or because of financial considerations. We know little beyond anecdotal data about which couples with fertility impairments seek infertility services and which do not. Research on infertility has not adequately examined the determinants of the use of infertility services. The clinical literature has focused on the medical and psychological roots of infertility (Kleinman and Senanayake, 1979; Mozley, 1985) as well as on the diagnosis and treatment of the condition (Atlas and Martinelli, 1979; Menning, 1976; Ollivier, Lesser, and Bell, 1984; Rosenfeld and Mitchell, 1979). The demographic literature has focused on rates of childbearing impairments, trends in infertility over time, and the sociodemographic characteristics of couples with fertility impairments (Mosher, 1985; Mosher and Pratt, 1982). A recent study by Horn and Mosher (1984) examined the use of infertility services among ever-married women 15-44 years of age. They found higher utilization rates among older and white women. It is unclear, however, whether these subgroup differences in utilization reflect group differences in rates of infertility or in the use of services among couples with fertility problems. To clarify this issue, it is necessary to hold fertility status constant by focusing on couples with childbearing impairments in analyses of the sociodemographic predictors of the use of infertility services. Understanding the determinants of help-seeking behavior among couples with impaired fertility is important for several reasons. First, infertility affects fertility rates, family size, and potentially, satisfaction with marital and family roles. As such, the utilization of infertility services is an important though neglected aspect of family and fertility behavior. In addition, information about the likelihood that different groups of couples with impaired childbearing capacity will seek help would enable us to identify underserved groups. These efforts will be aided by assessing whether group differences are due to differential motivation to use infertility services or to differential access to such services. Two key sets of factors may affect the use of infertility services. The first set relates to a couple's motivations to seek services and includes desire for children, parity, age, and fertility history prior to the current marriage. The second set relates to informational and economic access to these services. Socioeconomic variables are key here, as they affect a couple's access to knowledge about the availability of services as well as their ability to afford them.

Access to and use of infertility services in the United States: framing the challenges

Both the demand for and the availability of infertility services in the United States increased during the 1980s and early 1990s. Understanding the factors that are related to service-seeking among women with current fertility problems would aid efforts to better provide services. Data on U.S. women's use of infertility services were taken from the 1995 National Survey of Family Growth, a nationally representative survey of 10,847 women aged 15-44. For the 1,210 women who at the time of the interview reported having fertility problems, multivariate statistical modeling was used to identify the characteristics associated with their use of infertility services. Of the 6.7 million women with fertility problems in 1995, 42% had received some form of infertility services. The most common services ever received among these women were advice (60%) and diagnostic tests (50%), medical help to prevent miscarriage (44%) and drugs to induce ovulation (35%). The proportions of fertility-impaired women who had ever received infertility services were generally highest among those who were older, who had ever been married, who had graduated from college, who had a high income and who were non-Hispanic white. Multivariate analyses reveal that apparent differences by age and race or ethnicity in the unadjusted analysis disappear once the effects of women's marital status, income and private health insurance coverage are taken into account. Women who have ever used infertility services continue to represent a select group from among those with impaired fertility. Moreover, the vast majority of women with fertility problems who seek services receive noninvasive treatments that could be considered "low technology" interventions.

COVID-19 and Kidney Disease Disparities in the United States

Impact of subgroup analysis on estimates of infertility

Predictors of not pursuing infertility treatment after an infertility diagnosis: examination of a prospective U.S. cohort

This study aims to describe and analyze the extent to which the influence of the socio-economic status of parents on the learning outcomes of class students. The research method uses quantitative research with a descriptive correlative approach implemented at Madrasah Aliyah Persiapan Negeri 4 Medan. The population in this study were all students of class XI with a sample of 168 students. The data analysis technique in this study used a prerequisite test consisting of a normality test, a homogeneity test, a linearity test, and a multicollinearity test. Then continued with a hypothesis test consisting of a partial test (t test), a simultaneous test (F), multiple linear regression analysis, a determination coefficient test (R2) and a correlation coefficient test. The results showed that in the education level coefficient, the Tcount value <Ttable is 0.804 <1.97462, so H0 is accepted and Ha is rejected. This means that there is no influence of the level of parental education on student learning outcomes. In the income level coefficient, the Tcount value> Ttable is 2.348 <1.97462, so Ha is accepted and H0 is rejected. This means that there is an influence of parental income level on student learning outcomes. While in the work coefficient, the Tcount value <Ttable is -1.616 <1.97462, so Ha is accepted and H0 is rejected. This means that there is no influence of parental work on student learning outcomes. Then the probability value of significance (sig) <0.05 is obtained, namely 0.044 <0.05 and the Fcount value> Ftable is 2.762> 2.66, so Ha is accepted and H0 is rejected. So it is obtained that there is an influence of parental socio-economic status on learning outcomes which can be shown from the value of the determinant coefficient (R square) of 0.048, meaning that the influence of the socio-economic status variable on learning outcomes is 0.048 or 4.8%. While the correlation value (R) is 0.220 or 22% which indicates a low level of relationship. From the above understanding, it can be concluded that there is an influence of parental socio-economic status on student learning outcomes (Ha is accepted and H0 is rejected).

The Influence of Parents' Socioeconomic Status on the Learning Outcomes of 4th Grade Students at UPT SPF SDN Baddoka, Makassar City. This research aimed to determine the influence of parents' socioeconomic status on the learning outcomes of 4th-grade students at UPT SPF SDN Baddoka, Makassar City. The study used a quantitative research design with an ex post facto type of research. The population of this study consists of all students in class IVa at UPT SPF SDN Baddoka, Makassar City, totaling 28 students, while the sample comprises 20 students from class IVa using a non-random sampling technique (purposive sampling). Data collection techniques and instruments used are questionnaires and documentation, in the form of student learning outcomes, to identify the influence of parent's socioeconomic status on students' learning outcomes. Data analysis techniques include descriptive statistical analysis and inferential statistical analysis (normality test, linearity test, and hypothesis test). The result of the t-test calculation shows a significant value of parent's socioeconomic status at 0.003 < 0.05 (3.025 > 2.101), which means that H0 is rejected, and Ha is accepted, indicating that there is an influence of parent's socioeconomic status on the learning outcomes of 4th-grade students at UPT SPF SDN Baddoka, Makassar City. In conclusion, parent's socioeconomic status has a positive and significant influence on students' learning outcomes.

The achievement of university students is influenced by their socio-economic status as a result of the interactions between their socio-economic positions, work experiences, and families which react relatively on each other in relation to their incomes, occupations, and academic degrees. This study was conducted to investigate socio-economic status as the factor that influences the academic achievement of private university students. Furthermore, this socio-economic status factor divides parenting in relationship with children development into two distinct ways. A family that has low rate of income theoretically will be inclined to raise a child in lack of capability to afford excellence academic accomplishments. Accordingly, the objective set for this study was to find out the influence of socio-economic status on the academic achievement of private university students in Palangka Raya. Therefore, this study applied multivariate analysis to verify the influence of the socio-economic status of family on children’s academic accomplishments. This study also investigated the impact of age, gender, marriage status, income, region, education, and socio-economic status of the parents based on cross-section data collected in 2012 and 2015. Meanwhile, the result of this study was obtained from random sampling collected from three different private universities in Palangka Raya using questionnaire. Thus, the result attained from this study was that a stable socio-economic status has a meaningful influence on academic achievement of the students at private universities in Palangka Raya. In addition, a higher socio-economic status brings out some advantages to the students of private universities in Palangka Raya.

The Influence Of Race/Ethnicity And Socioeconomic Status On End-of-life Care In The Intensive Care Unit

Infertility services reported by men in the United States: national survey data

Characteristics of infertile women in the United States and their use of infertility services

This report describes changes in twin births from 2019 to 2021, which includes the period in late 2020 and early 2021 when reduced access to infertility services may have further impacted the already declining number of twin births. Changes are described by maternal age and by race and Hispanic origin because use of infertility services differs by these characteristics.

Limited research has addressed the barriers impeding access to surgical care for pediatric patients with hydrocephalus. To identify priorities for enhancing access to pediatric hydrocephalus surgical care and to address healthcare disparities, it is essential to understand the level of access to care and the influence of socioeconomic status (SES) and maternal health literacy. In this study, the authors aimed to assess the level of access to surgical care; determine the frequency of more than a 2-week delay in seeking, reaching, and receiving care; and investigate the influence of parental SES and maternal health literacy on these delays. This observational prospective cohort study involved data collection from a sample of 100 pediatric patients aged ≤ 5 years with hydrocephalus and their mothers, including information on family SES (education, occupational, and economic status). Maternal health literacy was assessed using the Brief Health Literacy Screen (BHLS) questionnaire. The Three Delays framework from the Lancet Commission on Global Surgery, categorizing delays in seeking care, reaching care, and definitive care, provided a structured approach for analyzing access delays. Statistical significance was set at p < 0.05. Among the pediatric patients, there was a male-to-female ratio of 1.7:1, with a median age of 1.5 months. None of the patients had insurance coverage that included surgical treatment. A significantly low number of patients accessed care within 2 weeks for seeking care duration (34%), reaching care duration (15%), and definitive care duration (1%). The median time to definitive surgical treatment for the entire study population was 14 weeks (upper SES: median 6.3 weeks, middle SES: median 9.8 weeks, lower SES: median 16.7 weeks). Through Cox proportional hazards regression, a hazard ratio of 0.046 (95% CI 0.010-0.210) was obtained. Multiple linear regression analysis identified BHLS Brief D (β = -0.335, p = 0.001) and SES (β = 0.389, p < 0.001) as predictor variables for delays in seeking care and definitive care, respectively. SES (β = 0.446, p < 0.001) and Evans index (β = 0.233, p = 0.010) were predictor variables for delays in reaching care. Maternal health literacy and SES were identified as factors associated with delays in accessing neurosurgical care for pediatric patients with hydrocephalus. To reduce disparities in pediatric hydrocephalus care, it is essential to implement strategies that promote education, improve healthcare infrastructure, and provide support to families encountering challenges related to low SES and limited maternal health literacy.

Objectives Previous studies have identified racial/ethnic disparities in infertility care, but patterns among American Indian/Alaska Natives (AI/AN) have not been reported. Our objective was to evaluate infertility services use in the US by race/ethnicity using data from the National Survey of Family Growth (NSFG). Methods We analyzed female respondent data from the pooled NSFG cycles 2002, 2006-2010 and 2011-2013. Respondents reported use of infertility services and types of services. We calculated weighted crude and adjusted prevalence proportion ratios (PPR) and 95% confidence intervals (95% CI) using modified Poisson regression with robust error variances accounting for the complex survey design to compare infertility services use across race/ethnicities. Results Overall, 8.7% of women reported using medical services to get pregnant. The prevalence of using any medical service to help get pregnant was lower for American Indian/Alaska Native (AI/AN) (PPR: 0.60, 95% CI 0.43-0.83) and black (PPR: 0.53, 95% CI 0.44-0.63) compared to white women and in Hispanic compared to non-Hispanic women (PPR: 0.57, 95% CI 0.48-0.67). The prevalence of accessing treatment, testing, and advice also differed by race and ethnicity. Conclusions for Practice We observed disparities in accessing services to get pregnant among AI/AN and black women and reduced use of advice among Asian/Pacific Islanders compared to whites. We also observed reduced service utilization for Hispanic compared to non-Hispanic women. Differential utilization of specific services suggests barriers to infertility care may contribute to reproductive health disparities among underserved populations.