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Correlation of State Political Party Strength and Performance of Assisted Reproductive Technology
Abstract Number: F3I-557
Abstract Type: Original Research
As the primary medical procedure to address infertility, assisted reproductive technology (ART) has helped many to reach their dreams of parenthood. Aside from common success factors such as age, previous pregnancy, and fertility related problems, economic and political factors may also contribute to infertility. We hypothesized that the trend of ART performance rates might have influence from the state’s political party strength.
Numbers of ART performances for 49 states from 2009 to 2015 were collected from the Center for Disease Control and Prevention. The District of Columbia and state of Nebraska were excluded from the study, since they have different party structures. Risk factors included state Growth Domestic Product (GDP), state insurance coverage for ART, and political party strength. We divided states into two groups according to their health insurance coverage legislation: the ones that require or offer infertility treatments (17 states), and the states do not offer coverage (32 states). With regards to the states’ political party strength, we focused on the change of power of state control. A linear mixed effect model with a time dependent covariate was used for analyzing the interactions between the risk factors and the number of ART performances.
Strong positive correlation between the state GDP and ART performances was found (p<0.0000001). The number of ART performances decreased if state control changed from Democratic to Republican or Divided (p=0.02), and increased if the shift was reversed in direction (p=0.009). States which do not offer healthcare with infertility treatments showed a significantly lower ART performance amount than those which do offer or require insurance coverage of infertility treatments (p=0.008). Among these figures, most of the states which offered infertility treatments are Democratic controlled (12 states). However, if no infertility treatment coverage offered or required, the number of ART performances from Republican controlled or divided states were higher than Democratic states (p=0.004).
Our study demonstrated significant fluctuations in the number of ART performances when state political party strength shifted, which implied sociopolitical influence on medical performance in general. This result further suggested that political factors could be a component of the underlying mechanism triggering health inequality in the United States. Despite that Democratic controlled states might have provided better healthcare, which led to higher ART performance rates, states with Divided or Republican controlled tend to have more ART cases with no treatment coverage. This implied that those Republican controlled or divided states might have supplementary public welfare benefits or other factors promoting ART. Further study should be performed to explore this matter.
1. Rodriguez JM. Int J Epidemiol 2014
2. Krieger N. J Epidemiol Community Health 2018