PUTTING HEALTH CARE IN SCHOOLS
School-based health centers (SBHC) can improve education (high school performance and graduation rates) and health (decreased asthma attacks and emergency room visits generally). In this study of more than 500 public high schools in California, students whose parents didn’t finish 12th grade had lower rates of alcohol bingeing, cigarette smoking, and marijuana use at schools with health centers, although the effects did not extend to Latinos. The convenience, availability, and trust in SBHCs may help address substance use and other mental health issues in high school students. But there may be a differential impact of SBHCs based on student race/ethnicity and socioeconomic status.
CHOOSING FRIENDS WISELY
Substance use usually begins during adolescence, influenced by close friends and social environment. Neighborhoods characterized by high levels of disorder (vacant homes, violent crime, unemployment, poverty) weaken neighborly trust and attachment, produce chronic stress, and undermine adolescents’ sense of control and confidence, increasing risk for marijuana and alcohol use. This study of 13-14 year-olds in Richmond, Virginia who already use at least one substance found that disordered neighborhoods create risks for increasing substance use over time. But this risk is notably reduced by adolescents having a “healthy” peer group, that is, three close friends who have little or no substance use. Healthy peer networks can protect young urban adolescents from harm, although they may be harder to find during the later teenage years.
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HOW FAR DO WOMEN HAVE TO TRAVEL TO GET AN ABORTION?
Abortion is a common experience for women across the United States. According to the Guttmacher Institute, about one in four women will have an abortion by the age of 45 in the United States. Access to this care can be affected by a variety of factors, including state laws and policies, socioeconomic status, and geography.
As shown in the map above, women who want to have an abortion performed in the middle of the country must travel much farther than women living on the coasts to reach a provider. The red areas indicate that women seeking an abortion must travel 180 miles or more. These areas in the middle of the country tend to be rural, with abortion clinics being concentrated in urban settings. Pink areas can also indicate long travel times that range from 90 minutes to three hours.
The distance needed to travel varies across the country, but it can also vary greatly within a state. In Alaska, about 50% of the women are just over nine miles away from an abortion provider, but 20% must travel over 150 miles to access care. Traveling these long distances can be impossible for women who cannot take time off from work or afford the transportation costs.
Some states that have implemented abortion restrictions in recent years have increased the distance women must travel. In Texas, 20% of women have had their travel distance to the nearest abortion provider increase by about 56 miles. Other states where distance and travel times have increased include Iowa, Montana and Missouri. —Chrissy Packtor, PHP Fellow
Map: Median distance to the nearest abortion provider by county, 2014, Alaska and Hawaii are inset in the bottom-left corner. The Lancet, "Disparities and change over time in distance women would need to travel to have an abortion in the USA: A spatial analysis," Dr. Jonathan Bearak et al., https://doi.org/10.1016/S2468-2667(17)30158-5
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