Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States
Abstract
Objective To identify cultural differences in access to infertility care.Design Cross-sectional, self-administered survey.Setting University hospital-based fertility center.Patient(s) Thirteen hundred fifty consecutive women who were seen for infertility care.Intervention(s) None.Main outcome measure(s) Details about demographic characteristics, health care access, and treatment opinions based on patient race or ethnicity.Result(s) The median age of participants was 35 years; 41% were white, 28% African American, 18% Hispanic, and 7% Asian. Compared with white women, African American and Hispanic women had been attempting to conceive for 1.5 years longer. They also found it more difficult to get an appointment, to take time off from work, and to pay for treatment. Forty-nine percent of respondents were concerned about the stigma of infertility, 46% about conceiving multiples, and 40% about financial costs. Disappointing one's spouse was of greater concern to African-American women, whereas avoiding the stigmatization of infertility was of greatest concern to Asian-American women.Conclusion(s) While the demand for infertility treatment increases in the United States, attention to cultural barriers to care and cultural meanings attributed to infertility should be addressed. Enhanced cultural competencies of the health care system need to be employed if equal access is to be realized as equal utilization for women of color seeking infertility care.
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Women who seek a medical evaluation for infertility differ from women who do not on important demographic, lifestyle, and access factors.
“Since women who seek a medical evaluation for infertility differ from those women who do not on important demographic, lifestyle, and access factors (Farland, under review for publication) (10–18) additional analyses of infertility type were conducted using male factor infertility as the reference group.”
From Infertility, fertility treatment, and risk of hypertension (2015) · cites this paper as [16]
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- Authors
- Missmer, S. A., Seifer, D. B., & Jain, T.
- Affiliations
- Brigham and Women's Hospital (US)
- Maimonides Medical Center (US)
- Corresponding author
- Jain, Tarun
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 95
- Issue
- 6
- Pages
- 1943-1949
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2005346792
- Cited by
- 144
- References
- 24
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 11 · 2023: 15 · 2022: 16 · 2021: 13 · 2020: 8 · 2019: 9 · 2018: 3 · 2017: 12 · 2016: 6 · 2015: 7 · 2014: 3 · 2013: 4 · 2012: 5
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- infertility, health care disparities, cultural factors, racial and ethnic differences, African American women, Hispanic women, Asian American women, infertility stigma, multiple pregnancy, infertility treatment costs, cultural competence, Midwestern United States
- MeSH terms
- Adult, Attitude of Health Personnel, Cross-Sectional Studies, Culture, Ethnicity, Female, Health Services Accessibility, Humans, Infertility, Female, Middle Aged, Surveys and Questionnaires, Midwestern United States, Causality, Reproductive Techniques, Assisted, Healthcare Disparities, Young Adult
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