The Political Determinants of Contraceptive Access


November is just around the corner. In August we celebrated the centennial anniversary of the 19th Amendment granting white women the right to vote. We must also recognize the injustices that still pervade our country—in this case, it would be another 45 years before Black women were able to exercise that same right. Now, as we head into election season, reproductive health is at the forefront. Amidst many other health policies, we must consider contraceptive access… and its political determinants of health.

Since Griswold v. Connecticut legalized the birth control pill for married women in 1965, contraception has been the subject of much political debate. In fact, it wasn’t until 1972 that the United States Supreme Court found that unmarried women had the same constitutional right to birth control as married women.

Fast-forward to July 2020, when the US Supreme Court upheld President Trump’s expansion of the religious and moral exemptions to the ACA’s 2011 contraceptive mandate in Little Sisters of the Poor v. Pennsylvania—the third time in six years that the Supreme Court has ruled on the contraceptive mandate. This case has left more than 70,000 people without access to free contraception. And not everyone is affected equally… Black, Latinx, and LGBTQ+ people are most impacted by these attacks on contraception.

As advocates for reproductive justice, we must ask ourselves: What truly shapes these health disparities? We must take one step past the social determinants of health to the root driver: the political determinants of health.

As advocates, clinicians, and leaders in our communities, it’s on us to draw this important connection between healthcare, health equity, and civic participation. We must vote. Clinicians must help their patients access their right to vote. And again, we must recognize that access to voting is not created equally. Voter suppression has a long history in the US, and this disproportionately affects people of color and low-income people.

It’s time to get to work. Talk with your friends, colleagues, neighbors, and patients about the importance of voting, ask them about barriers, and find ways to help them overcome some of those barriers. In the midst of the COVID-19 pandemic, there will be lots of obstacles to voting this year.  To start, help your patients get registered to vote and request a mail-in ballot here. And check out the voter ID requirements for your state here.

And lastly, please vote in November! Contraceptive access, and so much more, depends on YOU.

Post contributed by Dr. Rebekah Rollston



Block, M. (2020). Yes, women could vote after the 19th Amendment—but not all women, or men. National Public Radio. Retrieved from

Dawes, D. (2020). The political determinants of health. Retrieved from

 Gresko, J. (2020). Court: some employers can refuse to offer free birth control. US News & World Report. Retrieved from

Gross, T. (2018). Republican voter suppression efforts are targeting minorities, journalist says. National Public Radio. Retrieved from

Jackson, J. & Daley, D. (2020). Voter suppression is still one of the greatest obstacles to a more just America. Retrieved from

Keith, K. (2020). Supreme Court upholds broad exemptions to contraceptive mandate—for now. Health Affairs. Retrieved from

Planned Parenthood. (2015). The birth control pill: a history. Retrieved from

Planned Parenthood. (2019). Who’s most impacted by attacks on birth control. Retrieved from

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