Significant changes in human services over the past 50 years

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Significant changes in human services over the past 50 years

Thirty-eight percent of patients had no religious affiliation. Background Abortion is common in the United States and is a critical component of comprehensive reproductive health care.

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For example, population-based surveys, which are used to obtain information about many aspects of reproductive and sexual health, do not adequately measure the prevalence of abortion, and only about half of abortions provided in the United States are captured by these types of surveys.

To address these limitations, the Guttmacher Institute periodically collects information from U. The previous Abortion Patient Survey was conducted inand the landscape of reproductive health in the United States has changed in several important ways since that time.

In Januarythe Affordable Care Act was fully implemented, and it has reduced the number of women of reproductive age who are uninsured, mainly by increases in Medicaid coverage.

Between andstates enacted new abortion restrictions. These include waiting periods that may require patients to visit the clinic twice, requirements that abortion clinics meet the standards of ambulatory surgical centers or acquire hospital admitting privileges for their clinicians, and bans on the use of private insurance and plans purchased through state exchanges to pay for abortion services.

These trends may have also motivated more individuals to attempt to self-induce an abortion outside of a clinical setting. Between April and Junewe collected information from 8, respondents obtaining abortions at 87 facilities. We used a four-page, self-administered questionnaire available in English and Spanish.

Two versions were developed, and respondents were randomly provided with Module A or Module B; the modules were identical for all questions, with the exception of three items on current school enrollment, prior abortions and pregnancy timing.

Key demographic characteristics of abortion patients include age, relationship status, race and ethnicity, nativity, educational attainment, number of prior births, family income level, religious affiliation, prior attempts to self-induce an abortion, health insurance coverage and method of payment for abortion services.

One new measure—sexual orientation—was included in the survey. Weights were constructed to account for patient nonresponse and variation from the original facility sampling plan.

Missing information for key demographic variables was imputed using the answers of respondents with similar characteristics. All analyses were based on weighted data and were conducted using the svy command in Stata version Because is the most recent year for which the total number of abortions in the United States is available, we were unable to estimate the abortion rate the number of abortions per 1, women by subgroup for this report.

Instead, we constructed an abortion index or relative abortion rate as a proxy measure of rates to assess the relative levels of abortion across subgroups.

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Each abortion index is the proportion of abortion patients in a given subgroup e. If these proportions are the same—indicated by an index of 1. If the subgroup is overrepresented among abortion patients index greater than 1.

The abortion index of 0. In contrast, women aged 20—24 were overrepresented by a factor of almost two, having the highest relative abortion rate of the age-groups examined 1. Abortion indices declined with increasing age thereafter. Both younger and older adolescents had slightly lower abortion indices in than in ; there was little change in the indices for women aged 20 or older.

The distribution of abortion patients and abortion indices varied by relationship status. Cohabiting women were overrepresented by a factor of 2.

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The abortion index for never-married, noncohabiting patients was slightly higher than average 1. The abortion indices for most relationship statuses remained unchanged fromwith the exception of that for cohabiting women, which declined from 2.

Race and Ethnicity Disparities in reproductive health outcomes by race and ethnicity are well documented, 18—20 and may be an important indicator of systemic barriers to preventive services. No racial or ethnic group made up the majority of abortion patients in The racial and ethnic composition of patients was quite similar in White women were slightly underrepresented among abortion patients inhaving an abortion index of 0.

Hispanic women were slightly overrepresented among abortion patients in 1. The relative abortion rates for these two groups were proportional to the overall population of women of reproductive age in the United States and were comparable in both years.

Educational Attainment Educational goals are often cited as a reason to delay childbearing, as many individuals wish to complete their schooling and better position themselves economically before having children.

Abortion patients aged 20 or older with only a high school education were slightly overrepresented relative to the population of all women aged 15—44 abortion index of 1.

Between andthe relative abortion rate for women 20 or older declined slightly among those who had not graduated from high school from 1.

Prior Births How individuals achieve their desired family size—including the timing and spacing of any births—is often part of a complicated calculus, and decisions regarding pregnancy outcomes are made in the context of existing and planned children.

Significant changes in human services over the past 50 years

These proportions were largely unchanged from Individuals with one previous birth were overrepresented among abortion patients index of 1. Abortion indices by number of previous births showed virtually no change between and Income Level Over the last few decades, abortion and unintended pregnancy have become increasingly concentrated among poor patients.

We refer to patients in the lowest and middle categories as poor and low income, respectively.the future of managed long-term care After a lull in managed long-term care development activities over the last years, there appears to be renewed interest among states.

The Texas Health and Human Services Commission proposed a large expansion of the Star+Plus program to seven additional metropolitan counties and a request for .

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A. A1C A form of hemoglobin used to test blood sugars over a period of time. ABCs of Behavior An easy method for remembering the order of behavioral components: Antecedent, Behavior, Consequence.

Over the past 50 years, humans have changed ecosystems faster and more extensively than in any period in human history. This has been due largely to rapidly growing demands for food, freshwater, timber, fiber, and fuel. Human well-being depends notably on material welfare, health, good social relations, security, and freedom.

All of these are affected by changes in ecosystem services (see Box ), but also by the supply and quality of, for example, social capital and technology. When the supply of ecosystem services exceeds the demand, an increase in supply tends to enhance human well-being only . promotes a positive and cooperative understanding of the importance of language access to federal programs and federally assisted programs. - Over the past 50 years the most significant changes in human services has been the definition of specific target groups.

For example, disabled people and the elderly are provided protection by the government in the form of grants and other services.

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