DOI: 10.3886/icpsr38891.v1
title: Contraceptive Needs and Services in the United States, 1994-2016
title: Version 1

description: These data come from surveillance activities conducted by the Guttmacher Institute over several decades, collecting or compiling data for the period 1994 through 2016. These activities track the numbers of women who have a potential demand for contraceptive care (because they are of reproductive age, sexually active and not seeking to become pregnant), the subset of these women who likely need public support for care (because of their family income level or their age), the numbers of women who receive contraceptive services from publicly funded clinics, and the numbers of clinics providing publicly supported contraceptive services. These efforts have been conducted periodically, typically about every five years, but at times the intervals between efforts were shorter or longer than five years. The most recent data were collected or compiled for 2015 (women served) and 2016 (women with potential demand for services).
This release includes two separate datasets. Dataset 1, "Need for contraceptive services," provides county-level aggregate data for 6 different years (1995, 2000, 2002, 2006, 2010, and 2016). For each county, the data represent estimates of the number of women who have a potential demand for contraceptive services and the number who likely need public support for care, both in total, and according to key socio-demographic characteristics. Dataset 2, "Clinics providing contraceptive services and women served," provides county-level aggregate data for six different years (1994, 1997, 2001, 2006, 2010, and 2015). For each county, the data represent the number of publicly funded clinics according to clinic type and funding status and the number of female contraceptive patients served at those clinics.
description: The purpose of these data are to track the numbers of women who have a potential demand for contraceptive care, the subset of these women who likely need public support for care, the numbers of women who receive contraceptive services from publicly funded clinics, and the numbers of clinics providing publicly supported contraceptive services.
description: <strong>Need for contraceptive services (Dataset 1):</strong> For each surveillance year, county-level estimates are provided for the total number of women of reproductive age (aged 13-44), the number of women with potential demand for contraceptive services and supplies, and the number who likely need public support for care according to age-group (younger than 18, aged 18-19, aged 20-29, and aged 30-44), family income level (less than 100 percent, 100-137 percent, 138-199 percent, 200-249 percent, and greater than 250 percent of the federal poverty level), and race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic other race/multi-racial). County-level numbers are also summed to provide state and national estimates.
These estimates are produced by combining county-level population data from the U.S. Census Bureau with information on poverty and marital status from the American Community Surveys (ACS) and characteristics of women from the National Survey of Family Growth (NSFG). Information describing which census, ACS, and NSFG years were used for each surveillance year can be found in the background methodology of each published report (see the documented references in the User Guide).
The research team specifically used the NSFG, a nationally representative cross-sectional survey of women aged 15-44 conducted by the U.S. National Center for Health Statistics, to calculate the proportion of women in various population groups who met certain criteria indicating their likelihood of being at risk for pregnancy and having a potential demand for contraceptive services. Women were included in the analysis if they had ever had consensual sex, were fecund, and were neither pregnant nor trying to become pregnant for the entire year. The proportion of women with a potential demand for contraceptive services by each age by marital status by income level by race and ethnicity group were then applied to county-level estimates of the number of women in each of these population groups. See the User Guide and the documented references for further detail on the methodology used to generate these estimates.
<strong>Clinics providing contraceptive services (Dataset 2):</strong> For each surveillance year, county-level aggregate estimates are provided for the number of publicly supported clinics and the number of female patients receiving contraceptive services from these clinics through primary data collection.
The research team first identified all publicly supported agencies and clinics that provided contraceptive services. Data were collected for each clinic, specifically the total number of female contraceptive patients served, the number of those patients who were younger than 20, and whether the clinic received Title X funds. They used the Guttmacher universe of publicly supported clinics, updating addresses and adding potential new clinics from the following sources: the online directory of Title X-funded clinics and the online directory of Planned Parenthood health centers.
Data were obtained through requests to administrative agencies that oversee clinics, including the Office of Population Affairs (OPA) in the U.S. Department of Health and Human Services; the Health Resources and Services Administration (HRSA), which provides data for federally qualified health centers (FQHCs) providing contraceptive services; and the Indian Health Service (IHS), which provides data for IHS sites that provide contraceptive services. Additional data collection activities were conducted with Title X grantees, State Family Planning Administrators, and individual agencies and sites that do not report to any of these entities.
Two methods were used to estimate how many patients were served for non-respondent clinics (10 percent in 2015). First, the research team used counts obtained during a prior enumeration of patients as a proxy for current patient caseloads (6 percent of clinics in 2015). For the remaining clinics, the research team imputed counts using the average number of patients served by other clinics in the same region and of the same Title X funding status, metropolitan status, and provider type (4 percent of clinics in 2015).
Some of the data received were applicable to a reporting period other than calendar year, usually a fiscal year that included part of the calendar year. In those cases, the research team used the data provided, assuming that the number of patients served during the calendar year would have been similar to the number served during a partly overlapping 12-month fiscal year. Additional information on the data collection methodology, non-response rates and imputation methods, and key findings for specific surveillance years can be found in the User Guide, documented references, and the Appendix II documentation tables.
description: With the exception of geographic identifiers for state (STATENAME, STATEFIPS) and county (COUNTYNAME, FIPS), and the NOTE variable in Dataset 1, all variables are numeric in type.
The NOTE variable in Dataset 1 contains information about changes in county definitions across survey years. These counties can be identified by the COUNTYFLAG variable.
The LEVEL variable indicates geographic level - national, regional, state, or county. Rows can be uniquely identified by a combination of level, year, and the geographic variable corresponding to the level of interest. For example:
Level = 1 and year identifies national record for each year
Level = 2, year, and region identifies regional records for each year
Level = 3, year, and state identifies state records for each year
Level = 4, year, and FIPS identifies county records for each year
description: These data are not weighted.
description: Response Rates: For clinics providing contraceptive services (Dataset 2), the response rate (percent of the universe for which data were obtained) for each data year was: 1994, 88 percent; 1997, 86 percent; 2001, 89 percent; 2006, 84 percent; 2010, 90 percent; and 2015, 90 percent. (See the User Guide for detail on imputation methods for non-respondent clinics.)
For need for contraceptive services (Dataset 1), response rates are not applicable.
description: For clinics providing contraceptive services (Dataset 2), for each surveillance year, the research team first identified all publicly supported agencies and clinics that provided contraceptive services. Data were then collected for the entire universe of clinics. To identify agencies and clinics fitting the study's definition of a clinic providing publicly supported contraceptive services, the research team used the Guttmacher universe of publicly supported clinics, updating addresses and adding potential new clinics from the following sources: the online directory of Title X-funded clinics and the online directory of Planned Parenthood health centers. Data requests were mailed to administrative agencies and individual agencies and clinics.
For need for contraceptive services (Dataset 1), sampling is not applicable.
description: Datasets: 
DS0: Study-Level Files
DS1: Need for Contraceptive Services Dataset
DS2: Clinics Providing Contraceptive Services and Women Served Dataset
description: Need for contraceptive services (Dataset 1): Women of reproductive age (13-44)
Clinics providing contraceptive services (Dataset 2): All publicly supported agencies and clinics that provided contraceptive services. Smallest Geographic Unit: County
description: mail questionnairePlease see the Guttmacher Institute website for additional information.