Questioning Citizenship and the Undermining of the US Census

October 3, 2018

On September 21, a federal judge ordered the Trump administration to make its main official behind the 2020 census citizenship question — Commerce Secretary Wilbur Ross — available to testify out of court for the lawsuits over the hotly contested question.  More than two dozen cities and states have filed lawsuits to try to remove the question.  The Gender Policy Report sat down with demographer Sara Curran to get some background on the Census and the inclusion of an immigration question in 2020.


Debra Fitzpatrick: Welcome to a Gender Policy Report interview featuring Sara Curran. Sara Curran researches migration, globalization, gender, climate change, and adaptation and development. And she’s here with us today to discuss the 2020 census and the citizenship questions. So, Sarah, maybe you can start by just telling our audience a little bit about the basics of the census, and some specifics about how and why a citizenship question has been added.

Sara Curran: Okay. The U.S. constitution requires that we have a full enumeration of the U.S. population, and that’s really quite a profound statement for the founders of the country to have said that they needed to know who was where in order to best assess the needs for particular kinds of political representation in the country. And, we have consistently implemented a census. So, the census has had various questions over its history. Typically, it has, over-time, grown in length in the number of questions and it has shrunk in the number of questions. Most recently, it used to be that the census was collected by individuals going around and delivering the census; census data collectors, enumerators. In more recent years, certainly in the second half of the 20th century, we’ve really been asked to fill out the census forms ourselves as opposed to having an enumerator come to our house. And because of that, the census questionnaire has gotten shorter, in terms of the number of questions in order to make sure we could get enough people to respond and not make it too difficult with too many complicated questions. So, that’s the basics.

It’s done every ten years, it takes a fair amount of effort. There’s an entire government agency to collect those data, the U.S. Census Bureau, and they spend many years within the decade, both finishing up and cleaning the data and getting it ready for use by legislatures and states and officials across the country, and then they have to start preparing for the next round. So, we are less than two years away from the launch of the 2020 census and the Trump Administration decided to, Secretary Ross of the Department of Commerce, decided that we really needed to have a question about U.S. citizenship added to the census.  He made that declaration in early 2018. Which was very late in the process. So, we already had a set of questions, we already had a set of processes underway for the U.S. census, we have to do a lot of pretesting with all of our methods for collecting data in the U.S. census, and this edition came at the eleventh hour, right before they were finalizing and closing any new changes to the census.

Deb: So, what are the expected consequences are in terms of census participation and accuracy of adding this particular set of questions?

Sara: Well, there’s a fair amount of concern about this subject. So first of all, maybe I’ll back up and say that we do collect, the U.S. Census Bureau also has another way in which they collect data on an annual basis called the American Community Survey. And on that survey, they collect citizenship information on a sample of the U.S. population and those data are used to inform all sorts of questions around voting rights which was the purported reason why Secretary Ross wanted to add the question to the U.S. Census this round. Because we have been collecting citizenship questions and data on these other forms, we do know something about the extent to which response rates vary using the American Community Survey information, we know that we actually get reduced response rates when people who are of different kinds of statuses in the United States, by race, in particular by ethnicity, we get a reduced response rate because of the question of the census. That is, the citizenship question. So, there’s a fairly strong, even if somebody is a citizen but they recognize that citizenship question as a threatening kind of question of their legitimacy as a resident of the United States.

Deb: Can you say a little bit then about how having this accurate census data impacts efforts at various levels to understand and address gender disparities? And when we talk about gender, we’re really looking at that intersectionally, as gender intersects with race, ethnicity, in this case immigration status.

Sara: The census provides us with the best denominator for any kind of estimation of knowing exactly who is included in your base population and because it’s a full enumeration, we really can get a lot of detailed information that we otherwise have a very hard time getting from marginalized populations or somewhat more hidden populations. So, whether that is sexuality or whether that’s about ethnicity and being a woman, we get enough information from the census because it’s such a large count of the population. We can learn a lot about the needs of our country just based on a little bit of information from a person, but collectively we learn a lot more than we would from a random sample approach to collecting data.

Deb: How do you use census data or how do researchers like you use census data? What kinds of questions can we answer when we have this improved baseline sense of who resides in the United States?

Sara: What we know is what do you identify with as your ethnicity and your race. We know your age and we know who you’re living with, and we know where you’re living. And those kind of basic, fundamental pieces can tell us a lot, if we’re trying to get a sense of residential segregation, or if we’re trying to get a sense of social service needs, schools, or government resource allocations. One of the ways in which I am interested in these data and using these data, and particularly these rich data is when we have natural disasters, or when we have, particularly related to climate change and climate disasters, we need to know where people live exactly, how old they are, how vulnerable they might be, and just that kind of basic information about whether you are living alone, do you live with a family, do you have very elderly people; all of that gives you a tremendous amount of information that you can use for planning purposes and policy purposes and preparing for the possibility of disaster and finding potentially vulnerable populations.

The census data, because they’re so complete, they are useful for checking the quality of the representation of other samples and surveys. So if we know already a general baseline distribution of men, women, a particular age group, etc., we can double check to make sure that the distribution that we have in our sample is actually the distribution that we would have expected given what we know from the census.  Please know that we don’t use the census lists to draw our samples, but we do use the counts to help us know whether our survey samples are representative. So, it’s a very important validation of the quality of a sample survey. So, that’s just one piece. The other piece is that the census guides the distribution of federal dollars based on an accurate count. So, this is absolutely essential. And if there’s any doubt to the extent to which the census is inaccurate, one can imagine that this will lead to legal battles for many years. So, undermining the integrity of the census by adding a question like this that might actually diminish our ability to count people and open a pandora’s box of policy challenges and through many programs – whether those of local governments, the private sector or the federal government into some disarray. It’s a potentially dangerous path to go down.

Sara Curran is a professor of International Studies at University of Washington’s Henry M. Jackson School of International Studies. She holds a joint appointment as professor of Sociology, is Director at the Center for Studies in Demography and Ecology, and another joint appointment at the Daniel J. Evans School of Public Policy and Governance. And, she is an adjunct professor in the Department of Global Health.

Does Mandatory Sexual Misconduct Training Make Campuses Safer?

By Carlos Contreras and Melanie Sayuri Dominguez | September 12, 2018

A 2011 “Dear Colleague” letter issued by Barack Obama’s Office of Civil Rights reaffirmed that sexual violence in educational institutions constitutes a Title IX violation. The letter reminded colleges that Title IX and Clery Act compliance – and continued federal funding -requires on-campus training programs to prevent and reduce sexual assault and harassment. As the schools struggled to end the problem of sexual misconduct, they mandated students, staff, and faculty to participate in online or in-person trainings. All of this prompted our team to ask the rather straightforward question: Does mandatory training actually help change campus climates and reduce sexual misconduct?

Our ongoing study, co-authored with Mala Htun, Francesca Jensenius, and Justine Tinkler considers the effects of policies like these and may serve to inform other organizations considering mandatory training. We use data from a case study of a diverse university in the Southwest that introduced mandatory training for all its 27,000 students. With more than 760 student surveys administered before and after the training and 33 in-depth interviews, our data helps illuminate students’ understandings of sexual assault and harassment, attitudes about the issue, and experiences with the training.

Like most policies, the training appears to have both positive effects and unintended consequences.

In this preliminary data, we find that students – particularly men – who undergo training are less likely to endorse “rape myths” including dismissing sexual assault with statements like “she asked for it” or “she may have provoked him” and the idea that women may use rape accusations as a form of revenge. Because such rape myths contribute to normalizing sexual violence and rape culture, it is a relief to learn that mandatory training helps dispel these attitudes among students.

Further, those who complete training report that they are more likely to think campus authorities would believe them if they reported an incident of sexual violence. Students expect they will be taken seriously if they speak up about harassment and assault.

Among the unintended and concerning consequences of the training, however, we find that both male and female students are less likely, after training, to say they would report an incident of sexual assault.

Two plausible explanations for this shift include individuals’ general dislike of mandatory training and individuals’ new-found understanding of the complexity of sex on campus.

First, as Dobbin, Schrage, and Kalev 2015 suggest, people chafe against institutional mandates and rebel against initiatives they think are meant to micromanage them. This is to say, mandating training may activate social biases, even as it changes individual attitudes. Many of the students we have interviewed expressed resentment for being forced to sit through a 1.5 hour long training, even if they acknowledged that it was important.

Second, the students reported that the training’s focus on how complex campus sex can be led to a post-training hesitation to report sexual violence. Specifically, they recognized that many sexual encounters involve drugs and/or alcohol, which, as the training put it, makes it impossible for anyone to truly consent. In general, students want to avoid both explaining themselves to authorities and potentially getting into trouble.

Those who use substances said they would not report an assault because they would believe they were “responsible” for whatever of a sexual nature may happen to them.

After training, students were also markedly more likely to uphold traditional gender stereotypes – a finding that has come up in other types of trainings in other contexts (Tinkler 2008, 2012, 2013), but should also make universities take pause in designing their sexual assault trainings toward their student population. Both male and female students were more likely to describe men as not respected and followers, and women as incompetent, not respected, powerless, and incapable. One interviewee recalled experiencing distance and alienation from the “other” gender present in the training.

Concrete policy recommendations are starting to emerge from this ongoing research. The development of targeted training sessions for certain groups (based on gender, cultural identities, lifestyles, histories of victimization, and even ideology) is one promising idea, as is dividing the training into individual sessions with specific goals such as learning about consent, encouraging healthy and respectful relationships, reporting procedures, and sexual violence awareness. Finally, these programs should be offered in a variety of formats including lectures, panels, workshops, in-class discussions, conferences, digital sources, and student events to achieve maximum impact.

— Carlos Contreras and Melanie Sayuri Dominguez are Ph.D. students in Political Science at the University of New Mexico.
–Photo by the Michigan Daily

Shaming and Blaming Mothers Under the Law: It’s Time We Stop Expecting Mothers to Be Perfect

By Linda C. Fentiman | September 6, 2018

The perfect mother is a ubiquitous, if impossible, part of American life. We see her in spandex at the gym, working out—self-care!—a week after delivering twins. She’s at center-stage when internet experts opine about how mothers can prevent teenagers’ opioid addictions. In the shadow of this unattainable, idealized vision of a mother as a virtual guarantor of their children’s health and happiness, actual mothers berate themselves for falling short of perfection, feeling ashamed and inadequate.

In the American legal system, the pervasive stereotype of the perfect mother can lead to serious consequences, dramatically distorting the judgments of police, prosecutors, judges, and jurors.

The idealized image of motherhood is incorporated into law through the standard of “the reasonable person”; juries are asked to decide, in a particular case, whether the defendant’s behavior falls below this standard and is therefore negligent or worse. In a society that expects women to be more careful than men and holds mothers to an even higher standard of care and solicitude, many people will unconsciously impose the attributes of “the perfect mother” on the “reasonable person” or “reasonable mother.”

As a result, mothers and pregnant women are increasingly charged with, convicted of, and punished for crimes on the basis of perceived deviation from the perfect mother standard.

For example, in 2004, Utah prosecutors charged Melissa Rowland with murder after one of her twins was delivered stillborn. The prosecutors asserted that Rowland had demonstrated “maternal selfishness” by declining to have a caesarian section and her “depraved indifference to human life” meant she should be convicted of murder.  In 2010, Christine Taylor fell down the stairs in Iowa; since she was pregnant, she went to the hospital to make sure that both she and her pregnancy were okay. When Taylor, whose husband had just abandoned her and their two young daughters, disclosed that she was ambivalent about the pregnancy, she was arrested—her fall was taken for attempted feticide. Another mother, Ginger McLaughlin of Oregon, was convicted of criminal child neglect after her husband, who had been violent to her other children eight months prior, killed their young infant while Ginger was grocery shopping.

My book, Blaming Mothers: American Law and the Risks to Children’s Health, demonstrates how powerful images of maternal perfection unconsciously influence key players in the legal and health care systems, making it more likely that mothers, and not others, will be held responsible for adverse effects on their children’s health.  Because the legal system largely assesses criminal responsibility and civil liability with the benefit of hindsight, it is easy for unconscious psychological mechanisms to influence our judgments about risk (how likely is it that a bad event will occur) and whether a mother/parent could have acted to prevent that risk.

These mental shortcuts, sometimes known as “heuristics,” couple with our biases and stereotypes about race, gender, and class and have an outsize impact when the actions – or inactions – of a mother are under scrutiny.

Blaming Mothers builds on the research of leading social science and legal scholars – Martha Chamallas, Dan Kahan, Cynthia Lee, and Paul Slovic, to name a few – to explain how judges and jurors can have skewed perspectives when it comes to the culpability of mothers, particularly when these mothers are poor, black, or brown.

Every year, American mothers are prosecuted for homicide or child abuse when their children are killed or injured by their male partners. The converse—a father being prosecuted for abuse perpetrated by his female partner—is far less likely.  Most of these “child abuse by omission” cases are resolved by plea bargains; a small number of cases go to trial, and even fewer are the subject of an appeal.  In Blaming Mothers, I examined 108 appellate court decisions involving a parent’s failure to act to protect a child from a spouse or partner, published from 1960 to 2014. Eighty-seven of these defendants were mothers and eleven were fathers; ten defendants were either stepparents or the boyfriend or girlfriend of the abuser.  In about 40% of these cases, the mother was abused by her partner; in a cruel irony, that abuse is often used as evidence against mothers. Reflecting a persistent failure to understand how difficult it is for battered women to flee their abusers, one Oklahoma prosecutor reframed the mother’s status as a victim of abuse as a personal preference.  He argued against the mother of a murdered child, “She made the choice to stay…. It’s about putting your child at risk because of the choices you make, and the choices you make to stay in an abusive relationship.”

When juries interpret the legal standard “the reasonable parent” to mean “the perfect mother,” it is easy for them to convict any female parent who failed to prevent harm to a child by her abusing spouse or partner.

Substantial numbers of jurors, judges, and prosecutors appear predisposed to believe that single mothers, in particular, are highly sexualized beings, whose behavior must be closely scrutinized for evidence that lust overcame their maternal instincts. Nearly a quarter of American children live with a single mother, compared with 4% who live with single fathers. More than three quarters of children under eight living with single mothers are poor; two-thirds of these families receive no child support from the father.  Poor children are seven times as likely to be abused as those who live in middle-class and wealthier homes, and it is often the single mother who is blamed, both for the abuse and even for the poverty itself.

In contrast, consider how easily corporations have escaped responsibility for the harm they have caused children. Many corporations have successfully dodged public accountability for causing environmental harms, including lead poisoning, by exploiting society’s relentless focus on the perceived failings of mothers. Corporate defense attorneys have traded on our unrealistic expectations of mothers, deflecting blame away from their clients. In a leading commentary on childhood lead poisoning litigation, Daniel J. Penofsky, notes, “the chief defense strategy in such cases is to ‘trash’ the family.” Usually the “family” means the mother.

The federal government banned lead in paint in 1978, yet four decades later, children are poisoned by lead poisoning, condemned to struggle in school and in the job market.  The Centers for Disease Control put new annual cases of childhood lead poisoning at half a million, and one-third of our nation’s housing stock is still contaminated with lead paint. A landmark Wisconsin case, Thomas v. Mallett, involved Steven Thomas, a toddler who was severely injured by exposure to toxic levels of lead in the paint of his dilapidated home. Steven’s blood tests revealed very high lead levels, and psychological testing showed learning disabilities and low IQ, yet the jury declined to hold lead paint manufacturers accountable. Their attorneys argued that Steven’s limited intellectual abilities and behavioral problems were not due to lead exposure, but rather to “the home, the environment, [and] the genetics that he came from.”  The manufacturers’ expert witness explicitly attributed Steven’s disabilities to his mother, who had a “history of alcohol abuse” and a “poor diet,” as well as a “borderline” IQ.

Amid serious, documented injury caused by lead-containing products, not one American lead paint manufacturer has been held liable for harms like these. California is the only state in which manufacturers have been held responsible for cleaning up the public nuisance created by decades of marketing paints they knew to be toxic to children, and that appellate court ruling has been submitted for Supreme Court review.

The American Academy of Pediatrics has recognized that poverty is the single biggest risk to children’s health and well-being. Poor children are much more likely than their wealthier peers to live in substandard, toxic housing, and to lack nutritious food, safe places to play, and quality health care. The result is more physical and mental illness, lower academic achievement, and shorter lifespans.

Thus, to truly promote the health of our nation’s children, we must do more than decry society’s preoccupation with the idealized “perfect mother,” solely responsible for the health and safety of her children.

We must educate the public, health care professionals, and legal players about the power and dangers of unconscious stereotyping, and we must seek legal change. The law must actively constrain the exercise of discretion by police and prosecutors, to narrow broadly worded statutes to limit the opportunities for overzealous charging, and provide robust judicial review of charging decisions and convictions.  Further, rather than responding to realized harms with criminal charges after the harms have occurred, government should act prophylactically, identifying and intervening when children and families are at risk for environmental harm, domestic violence, and other health problems. Girls and women need high quality health care if we are to promote healthy pregnancies and minimize the risks of preterm birth, and there are plenty of proven programs, like the Nurse-Family Partnership, that could be effectively expanded to provide health education and support to mothers. Because the perfect mother is a myth, strong social safety nets and precautionary legal interventions can and should help safeguard children.

— Linda C. Fentiman is a professor of criminal law and health law at the Elisabeth Haub School of Law at Pace University
— Photo by Carol Von Canon

Bringing Women to the Table in California’s Corporations

By Jennifer M. Piscopo | August 21, 2018

Gender quotas for corporate boards raise the proportion of female directors, because waiting for companies to voluntarily add women to their boards has proven an extremely long-game. In fact, even threatening companies with quotas can boost women’s appointments. As California considers the move, Europe provides evidence of its effectiveness.

This August, California could become the first U.S. state to adopt gender quotas for corporate boards. The potentially precedent-setting bill has passed the state Senate, but opposition has emerged as the state Assembly begins deliberations. The deputy editorial editor of the Los Angeles Times referred to the measure as “social engineering at its worst,” and the California Chamber of Commerce argued the bill would reduce efforts to achieve workplace diversity by privileging gender over other identities. But the research is clear: state regulation is the only proven effective tool for speeding up women’s appointment to corporate board positions.

The California Assembly has until the end of August to decide whether the bill, cleared by its Senate in May, becomes law. Authored by two women senators, SB-826 requires publicly held companies headquartered in California to have at least one woman on their boards by the end of 2019 and to have larger ratios in place by 2021. Noncompliant companies would face a fine.

Iowa currently requires gender balance for all public boards at the state, county, and city level, but SB-826 would make California, often a bellweather state for legislation of all kinds, the first to impose gender requirements for businesses. Even if SB-826 fails, my research shows that this mere threat of regulatory action can increase women’s presence on boards. State legislators around the country looking to promote gender equality should take notice.

 Voluntary action is not enough

Those opposing corporate board gender quotas are putting their faith in pipeline theory – the notion that, over time, more talented women will gain the requisite experience and skills to be appointed to boards. The numbers, however, show there are already plenty of talented women, but few female directors. Of companies headquartered in California, 61 percent have one or no women on their boards, despite the fact that the state ranks in the top ten for numbers of women-owned businesses. The rate of change is glacial: In 2013, women held 13.3 percent of board seats. Today, women hold 15.5 percent of the seats.

Corporate quotas have become popular solutions to the “pipeline’s broken promise,” principally in Europe, but also in places as diverse as Israel, Malaysia, Kenya, South Africa, and Quebec. With Susan Clark Muntean, I tracked the rhetoric underlying corporate quota adoption in 22 Western European and Anglo democracies. We found that countries passed corporate quota laws once ministers adopted a “time’s up” language. In Germany in 2011, Chancellor Angela Merkel gave German companies “one last chance” to take voluntary action toward gender parity. Progress proved unsatisfactory, and Germany adopted a 30 percent quota for women on corporate boards in 2014. The measure took effect in 2016, and recent studies found that women held 29.7 percent of seats on the supervisory boards of Germany’s largest public companies.

What corporate quotas look like

We counted sixteen European or Anglo democracies with corporate quota laws, all adopted since 2003, with Norway leading the way. The measures come in several forms, as shown in the table below. First are comprehensive laws, under which the quota applies to privately held and state-owned companies. Second are limited laws, where the quota applies to state-owned companies only. Last are soft quotas – these are not laws, but non-binding regulations in the country’s stock exchange listing or corporate governance code requiring that listed companies have targets for gender diversity on their boards. Some countries combine their legal quotas for state-owned companies with soft quotas for privately held companies.

Corporate Quotas by Type and Year (Most Recent Reform)

Both comprehensive and limited laws typically contain target dates and phase-in periods. For instance, Italy required that companies achieve 20 percent women on their boards by 2012 and 33 percent by 2015. They also include some form of financial sanction for non-compliance, as in the case of Belgium, Denmark, France, Italy, Norway, and Spain. The proposed California law thus follows global trends in ramping up the quota threshold over time and penalizing noncompliant firms.

Raising the proportion of women through coercion

 We also examined how different quota types – comprehensive, soft, or no quota – affect growth in the national-level proportions of female directors. First, we found that countries without quotas had no growth or even lost ground in appointing women to boards. By way of example, the U.S. actually had fewer female directors in 2013 than in 2005.

Second, we found that some countries with comprehensive laws made enormous gains, while others made few. This pattern held for countries with soft quotas.

Put differently, not all quotas are equally effective.

For countries with comprehensive laws, statutory strength matters. Companies strongly resist corporate quotas – German carmakers such as BMW, Daimler, and Opel threatened to move production out of the country – but many laws, including the German one, actually exempt large companies. Further, many governments decline to enforce sanctions when faced with noncompliance. The countries that saw the most gains – Norway, Iceland, France, and the Netherlands – have comprehensive laws that limit exemptions and provide for enforcement. These were the only countries to raise their proportions of female directors ten or more percentage points between 2005 and 2013.

In countries with soft quotas that made comparable gains – Finland and Sweden, for instance – the key was ministers’ deployment of the “time’s up” rhetoric. German companies did not respond with sufficient swiftness to Merkel’s “one last chance” rhetoric, resulting in the country’s comprehensive law. But in other European countries, the threat alone spurred action.

In Sweden in 2002, for instance, the deputy prime minister requested 25 percent women on boards or the government would act. “The threat is real,” she said. By 2006, the proportion of female directors on Swedish boards had risen by 150%, or eight percentage points.

The upshot is that, in the short-term, credible threats can matter as much as actual statutes in getting more women appointed to corporate boards.

Moreover, the government’s credible threat carries more weight more than the companies’ protest– none of the carmakers shifted production outside Germany, even after the corporate quota came into effect.

If SB-26 passes, California could quite literally change the face of corporate America. And even if the bill does not succeed, its introduction could give women board members in the U.S. states a temporary boost – perhaps just the foothold women need to establish a permanent presence in corporate boards.

Jennifer M. Piscopo is assistant professor of Politics at Occidental College in Los Angeles, CA. @Jennpiscopo

Variation in Title X Leads to Contraception Deserts

By Tracee Saunders, Rebecca J. Kreitzer, and Candis Watts Smith | August 14, 2018

Title X of the Public Health Service Act is the only federal program devoted exclusively to family planning and reproductive health care. Title X is symbolic of the mid-20th century’s widespread and bipartisan support for policies aimed at increasing access to affordable contraception. More recently, the once-separate politics of abortion and contraception have converged. Just as we see a growing number of “abortion-free zones,” we are witnessing the growth of contraception deserts, or geographic areas with inequitable access to affordable family planning due to states’ broad discretion in Title X implementation. New and proposed reforms to Title X at the state and federal levels may expand contraception deserts.

This inequality isn’t trivial. Two-thirds of reproductive age women in the U.S. use contraception, and more than 20 million women require the assistance of public programs to afford that contraception. While many low-income people use Medicaid to access family planning, an additional 4 million rely on Title X each year. More than a third of this subset obtains their contraception at a Planned Parenthood clinic—the very clinics that have become the primary target of more than a dozen states’ new restrictions on the allocation of state and federal family planning funds. Further, Title X clients are among the most vulnerable populations: two-thirds have incomes at or below the federal poverty level, roughly half are uninsured (even after expansions to the ACA), 35% have coverage through Medicaid or other public programs, and many receive lifesaving STI and cancer screenings at Title X clinics. Yet despite the overwhelming evidence that affordable family planning reduces unintended pregnancy and abortion rates and decreases Medicaid expenses, at least a third of adult U.S. women who ever tried to obtain contraception reported barriers in accessing it.

Comparing Contraception Deserts in Two Red States

Title X funds are, for the most part, allocated at the state level, and the distribution of resources is influenced by state-level politics. With that in mind, we compare the equity of access to subsidized contraception through Title X in North Carolina and Texas (by “equity,” we mean resources are distributed in response to need). In North Carolina, the vast majority of Title X funds allocated in 2017 went to 112 county health departments as well as five Planned Parenthood locations. Although Texas has 5 times the landmass and nearly 3 times the population, it has only 94 service sites – just a smattering of federally qualified health centers, health departments, hospitals, Planned Parenthood, and a university health center.

Mapping Contraception Deserts

We identified two types of contraception deserts using a technique often used by applied geographers (the integrated two-step floating catchment area method). This method incorporates spatial barriers to access (e.g., minutes needed to drive to a clinic) with non-spatial ones (e.g., percent of an area’s inhabitants that are low-income). When the federal government considers whether a given place is a “Health Professional Shortage Area,” the guideline is that clients should need to drive 30 or fewer minutes to a clinic; we adopt this standard. But we also assess access using a 15-minute driving distance, because contraceptive dispensing patterns vary by method (e.g., oral versus implantable contraceptive methods) and many patients must visit a clinic for their birth control several times a year. In the first type of desert, marked in dark blue, most residents do not live within a driving time of 30 (or 15) minutes. In the second type of desert, light blue in our maps, many people live outside a 30 (or 15) minute driving distance and the area has a “high needs” population.

Our analysis reveals a greater set of disparities in the Texas in comparison to North Carolina. In North Carolina, Title X is distributed through most county health departments, so affordable family planning is fairly accessible throughout the state. In Texas, most Title X providers are in urban areas, where most people live. However, this leaves broad swaths of Texas with very limited access to affordable family planning.

How Many People Live in Contraception Deserts?

Many people live in areas characterized by limited access to family planning. Based on a 15-minute driving designation, 24.7% of North Carolina’s population (estimated 10.4 million) lives in an area with poor access to affordable family planning (summing the 11.7% living in an area with very poor spatial access and the 13.0% living with somewhat poor spatial access and high needs). The severity of contraception deserts in Texas is much greater. More than half of the state’s population (estimated 28.7 million) lives in a contraception desert.

Contraception Deserts in NC and TX, 15 minute driving distance

Contraception Desert Type # of Tracts (%) Area miles squared (%) Population (%)
North Carolina Spatial Access Very Poor 293 (13.5%) 6,224.27 (11.6%) 1,245,975 (11.7%)
Spatial Access Somewhat Poor + High Needs Population 268 (12.3%) 588.04 (1.1%) 1,202,199 (13.0%)
Texas Spatial Access Very Poor 1,966 (35.2%) 215,041.9 (80.1%) 9,662,682 (34.2%)
Spatial Access Somewhat Poor + High Needs Population 1069 (19.1%) 13,734.9 (5.1%) 5,127,532 (18.1%)

Even if we rely on the more conservative 30-minute driving distance standard, the number of people living in a contraception desert is remarkable: More than 2 million people or nearly 20% of North Carolinians and more than 10 million people or 35.4% of Texans lives in a contraception desert. And these are but two states.

Contraception Deserts in NC and TX, 30 minute driving distance

Contraception Desert Type # of Tracts (%) Area miles squared (%) Population (%)
North Carolina Spatial Access Very Poor 74 (3.4%) 224.11 (0.4%) 356,334 (3.4%)
Spatial Access Somewhat Poor + High Needs Population 393 (18.1%) 2,805.08 (5.2%) 1,662,027 (16.3%)
Texas Spatial Access Very Poor 1,087 (19.5%) 173,876.5 (64.7%) 4,642,172 (16.4%)
Spatial Access Somewhat Poor + High Needs Population 1,129 (20.2%) 20,411.9 (7.6%) 5,377,523 (19.0%)

The Future of Title X

We find that contraception deserts exist in both of these “red” states, but the severity varies. While more research is needed to better understand the different ways in which states implement Title X, including how those decisions are made, and which racial or ethnic groups across the U.S. are most likely to live in a contraception desert, it is clear that there are large inequities and that residents of some states are much worse off than others.

Title X was created to provide evidenced-based, effective contraceptive and reproductive healthcare to Americans in need. When people have access to affordable family planning, unintended pregnancy rates and abortion rates drop. Ongoing efforts to defund family planning resources have an impact on American fertility and perpetuate inequalities in unintended pregnancy rates across racial and socioeconomic classifications. Title X’s funding has decreased over five decades, and the Trump administration has now revised the criteria for awarding Title X grants to emphasize natural family planning (abstinence and the “rhythm” method) and eliminate emphasis on all forms of evidence-based contraception. The administration has also proposed a new rule that, if implemented, would prohibit clinics that provide abortions or abortion referrals from receiving federal family planning funds. In response, organizations like the American College of Obstetricians and Gynecologists (ACOG) have launched campaigns to oppose these changes and #SaveTitleX.

To mitigate inequitable access, policy advocates should fight for increased funding for Title X at the state and federal levels and for the establishment of additional clinics, especially in rural areas. Many social conservatives advocating to prohibit Title X funds going to Planned Parenthood and other similar clinics assert that the role of these clinics in providing low-cost contraception can be replaced with community health centers. Community health centers do play an increasingly critical role in the family planning safety net, but not all community health clinics offer a range of family planning options directly. Policy advocates must also continue to fight for Title X’s mission at the federal level. If funding for Title X continues to decline in the federal budget, state governments that fail to raise their funding for family planning risk an increase in abortion rates, unintended pregnancies, and Medicaid expenditures.

— Tracee Saunders is a Ph.D. student in political science at the University of Iowa studying social inequality, spatial politics, health policy and gender.
— Rebecca J. Kreitzer is an Assistant Professor of Public Policy at the University of North Carolina at Chapel Hill studying reproductive health, policy inequality, and women’s political representation in the U.S. states.
— Candis Watts Smith is an Assistant Professor of Public Policy at the University of North Carolina at Chapel Hill studying racial and ethnic politics and policy inequality. She is the author of Black Mosaic: The Politics of Black Pan-Ethnic Diversity.
— Photo by Surija/”Sray”

The Intersection of Interpersonal and State Violence Against Women

By Lisa Fedina | June 26, 2018

The problem of police brutality in the U.S. has largely and rightfully highlighted police killings of unarmed Black men. Still, when police violence against women can be connected to women’s personal experiences with intimate partner violence and sexual violence, researchers helping craft policy must work toward a comprehensive understanding of both men’s and women’s experiences with law enforcement.

Police brutality is not a new phenomenon. Researchers, scholars, and activists such as Andrea Ritchie, Kimberlé Crenshaw, and Hillary Potter and grassroots movements like #SayHerName and INCITE! have long described and documented the problem of police brutality – specifically, police brutality against women and trans women of color. The #SayHerName brief documents cases in which women call police to report intimate partner or sexual violence, only to be met with inadequate, harmful, and abusive law enforcement responses. INCITE! has explained how police violence and intimate partner violence intersect in the lives of women of color, including women of color who are trans, bisexual or lesbian, immigrant, undocumented, living on tribal land, have prior criminal convictions, or are involved in sex work.

Very little empirical research on these intersections in police violence against women has been conducted. To address this need, we conducted the Survey of Police Public Encounters (SPPE), a cross-sectional study aimed at describing the prevalence, nature, and mental health implications of police violence using a general population sample. SPPE was administered online to adult residents in Baltimore City, New York City, Philadelphia, and Washington, D.C. using Qualtrics Online Panels – a demographically representative sampling service (N = 1,615).

Our study measured lifetime exposures to police violence across four domains: physical violence, sexual

violence, psychological violence, and neglect (times when the respondent called for police, but police did not respond or were late in responding; see DeVylder et al. (2016) for more detail on the study’s measures and psychometric properties). The results, published in Preventive Medicine (January 2018), show that a substantial proportion of women in these four U.S. cities have experienced at least one form of police violence or neglect in their lifetimes.

Race and ethnicity was significantly associated with all forms of police violence. Latina women reported significantly higher rates of all forms of police violence and neglect, followed by Black women and White non-Hispanic women. Sexual minority women (i.e., lesbian/gay/bisexual) and younger women had higher rates of sexual police violence exposure than did heterosexual women and older women. Women with lower levels of income had higher rates of psychological police violence. And women with both lower levels of income and education reported higher levels of  police neglect.

The correlations between various forms of police violence and income, education, race, and sexual orientation suggests that these aspects of social location and, specifically, marginalization disproportionately subject women of color, economically disadvantaged women, and sexual minority women to police violence, abuse of power, and police non-protection. Although our study found the highest rates of police violence among Latina women, very little data is available to help us tease out the causes behind this inequality. One study, by LatinoJustice, found that the majority of Latinos in the U.S. are seriously concerned about their safety in the hands of police and believe they are mistreated by police in ways similar to African-Americans. Our study affirms that, at least among Latina women, such concerns are well-founded. A prior entry in Gender Policy Report describes how the current administration’s anti-immigration and “tough on crime” actions harms Latina women survivors of intimate partner and sexual violence. More research is needed, but experiences of police violence in Latinx communities likely intersect with ethnic identity and immigration status.

Women with histories of intimate partner violence and non-partner sexual violence were, in our study of urban respondents, more than twice as likely to experience most forms of police violence, even after adjusting for other factors. Given the documented problem of gender bias (e.g., myths, assumptions,

stereotypes) in policing of these cases, we had expected this result. Further, while it is possible that intimate partner and sexual violence victims are more likely to come into contact with police (necessarily leading to increased risk for police violence exposure), we controlled for other factors likely to increase police contact (i.e., histories of mental illness and criminal involvement) and prior research has documented the ways in which survivors have been met with neglectful, harmful, or abusive police responses, including women who had mental illness or substance abuse histories, lower incomes, and women of color (see Cuevas & Sabina, 2010; Potter, in Garcia and Clifford, 2010; Richie, 1996).

Our findings highlight the importance of creating policy that addresses police violence and its disparate impact on African American and Latino communities, including women of color. In the #SayHerName brief, recommendations are provided for creating gender-specific and inclusive policy to address police brutality against women of color, transgender, and gender non-conforming women, such as implementing and enforcing zero tolerance policies for sexual harassment and assault by police against civilians. Policing reform must also address the intersection of police violence and interpersonal violence in the lives of women of color, trans women, and women of other marginalized social locations.

The U.S. Department of Justice has previously documented the long-standing problem of gender bias in policing of interpersonal violence and sexual assault cases, and has issued guidance on improving police responses to victims. We must get more specific, however, if we are to prevent implicit and explicit bias in policing which may intensify the harm attending police responses to these victims. Tailoring departments’ policies by considering the agency’s history and relationship with the community, departmental climate, and resource needs is possible. The International Association of Chiefs of Police (IACP) and End Violence Against Women International (EVAWI) are currently implementing such approaches by including agency assessments and self-assessments, training and technical assistance, and coordinated community responses to intimate partner violence and sexual assault, with promise for improving police responses to the most marginalized victims.

— Lisa Fedina, MSW, PhD is a Postdoctoral Research Fellow at the University of Michigan School of Social Work. Her research focuses on gender-based violence, women’s health, and improving criminal justice, healthcare, and social service systems responses to victims of violence.
— Photo by All-Nite Images