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U.S. Department of Health and Human Services

Gaps in Contraception Access and Zika

Estimates of Contraceptive Need among Currently Sexually Active, Uninsured Women

Access to family planning services, including access to the full range of contraceptive methods to prevent unintended pregnancy is an important way to prevent Zika-related birth defects.  Sexually-active women who do not have access to contraception are at greater risk of an unplanned pregnancy.

Certain areas of the United States are at an increased risk for unplanned pregnancies with Zika-infected fetuses.  Cities with large diaspora populations and areas where the Aedes aegypti and Aedes albopictus mosquitoes are present are at increased risk for local Zika transmission.  Many of those areas also contain high concentrations of uninsured, sexually active women.

As indicated by the map, there are several areas of concern.  For example, the Aedes aegypti and Aedes albopictus mosquitoes are both present in Texas and the state contains two diaspora cities:  Dallas and Houston.  The state also contains many areas with large concentrations of uninsured women in need of contraception.  All states where the Aedes aegypti and/or Aedes albopictus mosquitoes are present also contain uninsured, sexually active women in need of contraceptive services.

Map of Estimates of Contraceptive Need among Currently Sexually Active, Uninsured Women by state.  For full data, see http://www.phe.gov/preparedness/planning/contraception/pages/data.html 

About the data:

The estimates shown on the map represent the number of uninsured women in a geographic area who are uninsured, currently sexually-active and in need of contraception. This includes women who are:

  • without insurance coverage
  • sexually-active in the past 3 months
  • of childbearing age (15-44 years old)
  • not sterile through either an operation (i.e. tubal sterilization) or who are not fecund for other reasons
  • not with a partner is sterile due to vasectomy
  • not pregnant or postpartum
  • not seeking pregnancy

The geographic areas provided include US States and Public Use Microdata Areas (PUMAs). PUMAs are statistically-defined areas that contain at least 100,000 people, cover the entirety of the United States, and are nested within states and territories. 

The accompanying data file includes several estimates.

Variable Name Definition

All women, age 15-44

Number of all women in this age range

Need contraceptives, total

Number of sexually-active women, age 15-44, who are in need of contraceptive services

Not in need of contraceptives, total

Number of women, age 15-44, who are not in need of contraceptive services

Need contraceptives, uninsured

Number of sexually-active women, age 15-44, who are uninsured and in need of contraceptive services

Need contraceptives, insured

Number of sexually-active women, age 15-44, who are insured and in need of contraceptive services

Need contraceptives, uninsured, percent of females 15-44

Percent of all women age 15-44 who are uninsured, sexually-active and in need of contraceptive services


The estimates are derived using data from three sources:

The HHS Office of the Assistant Secretary for Planning and Evaluation produced these estimates using a statistical model using the National Survey of Family Growth to identify the proportion of women nationally who are in different demographic categories that fit the above definition of being in need of contraceptive services. The model results were then applied to subnational geographic areas using the American Community Survey, accounting for different demographic compositions of those areas. 

Insurance rates were drawn from the state-level estimates from the National Health Interview Survey and local-level estimates from the American Community Survey.

Insurance status is an important indicator of access to contraceptives. However, insurance coverage does not necessarily mean that a woman’s contraceptive needs are met. Not all insured individuals may access contraceptives that are covered by their insurance plans, in part due to concerns over confidentiality. Insurance plans differ in the administrative and logistical steps to access some types of contraceptives, such as long-acting reversible contraception, which may present barriers for some women. In addition, uninsured women may have access to contraceptives, either through purchasing out of pocket, or through publicly funded family planning clinics, such as Title X clinics. While clinics are an important source of contraceptive services, not all need is met through clinics.

  • This page last reviewed: August 18, 2016