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The Impact of Women's Health Clinic Closures on Fertility

Author

Listed:
  • Yao Lu

    (Analysis Group)

  • David J. G. Slusky

    (Department of Economics, University of Kansas)

Abstract

In recent years, the government of Texas has enacted multiple restrictions and funding limitations on women's health organizations affiliated with the provision of abortion services. These policies have caused numerous clinic closures throughout the state, drastically reducing access to reproductive health care. We study the impact of these clinic closures on fertility rates by combining quarterly snapshots of health center addresses from a network of women's health centers with restricted geotagged data of all Texas birth certificates for 2008–13. We calculate the driving distance to the nearest clinic for each zip code and quarter, and find that an increase of 100 miles to the nearest clinic results in a 1.2 percent increase in the fertility rate. This increase is driven by a 2.4 percent increase in the fertility rate for unmarried women, while there is no statistically significant change for married women.

Suggested Citation

  • Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 334-359, Summer.
    • Handle: RePEc:ucp:amjhec:v:5:y:2019:i:3:p:334-359
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    File URL: https://www.journals.uchicago.edu/doi/pdf/10.1162/ajhe_a_00123
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    Cited by:

    1. Abdul Baki, Ghina & Beland, Louis-Philippe & Yazbeck, Myra & Zayat, Aline, 2025. "Reactance, rationalization, and women's rights for safe abortion: Evidence from Roe vs. Wade's overturn," Journal of Economic Behavior & Organization, Elsevier, vol. 233(C).
    2. Packham, Analisa, 2017. "Family planning funding cuts and teen childbearing," Journal of Health Economics, Elsevier, vol. 55(C), pages 168-185.
    3. Hill, Elaine L. & Slusky, David J.G. & Ginther, Donna K., 2019. "Reproductive health care in Catholic-owned hospitals," Journal of Health Economics, Elsevier, vol. 65(C), pages 48-62.
    4. Syed Hasan & Tasnima Akter & Musharrat Jahan & Ashraf Dewan, 2023. "Proximity to healthcare centres and service use: The case of Community Clinics in Bangladesh," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(3), pages 819-849, July.
    5. Lindo, Jason M. & Pineda-Torres, Mayra, 2021. "New Evidence on the Effects of Mandatory Waiting Periods for Abortion," Journal of Health Economics, Elsevier, vol. 80(C).
    6. Joanna Venator & Jason Fletcher, 2021. "Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 774-813, June.
    7. Lahey, Joanna N. & Wanamaker, Marianne H., 2025. "Effects of restrictive abortion legislation on cohort mortality evidence from 19th century law variation," Journal of Public Economics, Elsevier, vol. 243(C).
    8. Drake, Coleman & Nagy, Dylan & Eisenberg, Matthew D. & Slusky, David, 2025. "Medical cannabis dispensary availability improved self-reported mental health among older adults in New York," Economics Letters, Elsevier, vol. 250(C).
    9. Fischer, Stefanie & Royer, Heather & White, Corey, 2018. "The impacts of reduced access to abortion and family planning services on abortions, births, and contraceptive purchases," Journal of Public Economics, Elsevier, vol. 167(C), pages 43-68.
    10. Barton Willage & Marisa Carlos & Kevin Callison, 2023. "Non‐monetary obstacles to medical care: Evidence from postpartum contraceptives," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(4), pages 1045-1064, September.
    11. Clarke, Damian & Mühlrad, Hanna, 2021. "Abortion laws and women’s health," Journal of Health Economics, Elsevier, vol. 76(C).
    12. Martin Andersen & Sylvia Bryan & David Slusky, 2020. "COVID-19 Restrictions Reduced Abortion Clinic Visits, Even in Blue States," NBER Working Papers 28058, National Bureau of Economic Research, Inc.
    13. Balia, Silvia & Brau, Rinaldo & Moro, Daniela, 2020. "Choice of hospital and long-distances: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    14. Grace Arnold, 2022. "The impact of targeted regulation of abortion providers laws on abortions and births," Journal of Population Economics, Springer;European Society for Population Economics, vol. 35(4), pages 1443-1472, October.

    More about this item

    Keywords

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    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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