THE EFFECT OF CHANGES IN STATE AND FEDERAL POLICY FOR NONPRESCRIPTION ACCESS TO EMERGENCY CONTRACEPTION ON YOUTH CONTRACEPTIVE USE: A DIFFERENCE-IN-DIFFERENCE ANALYSIS ACROSS NEW ENGLAND STATES

摘要

One of the more contentious policy changes in the past decade in the United States involves the decisions by several state legislatures and the Food and Drug Administration (FDA) to permit sales of emergency contraception on a nonprescription basis. We took advantage of a set of natural experiments to estimate the impact of changes in state and federal level nonprescription emergency contraception access on the probability of high-school students' sexual and contraceptive behaviors. We extracted data from the Youth Risk Behavioral Survey for New England states that had data about contraceptive use (Maine, New Hampshire, Rhode Island, and Vermont) from 2003 to 2009. We combined this student-level data with information on when states and the FDA began allowing nonprescription sales of emergency contraceptives. We estimated a series of difference-in-difference models on the impact of these policies on the probability that students were sexually active and on the probability of condom or hormonal birth control use conditional on sexual activity. We found that switching emergency contraception to a nonprescription status had no systematic effect on the probability of sexual activity or the conditional probability of hormonal birth control use, but that it significantly reduced the probability that public school students used condoms by between 5.2% and 7.2%.