An Examination of State-Level Mandates for Insurance Coverage on Health-Seeking Behaviors for Infertility

Abstract

Health-seeking behaviors (HSB) for infertility are influenced my multiple factors. The Behavioral Model of Health Services Utilization states that enabling resources and predisposing factors are essential in predicting HSB, and this study examined the relationship between state-level mandates that insurance providers cover infertility service on the rates of HSB for infertility among a nationally representative sample of women.

This study used data from the National Survey of Family Growth, identified 15 states with state-level mandates as enabling resources, and used sociodemographic characteristics as predisposing resources. Using discrete-time event-history analyses, and retrospective accounts of infertility HSB, these variables were examined to determine if residing in a state with state-level insurance mandates would increase the likelihood of HSB for infertility.

Results indicated an impact of state-level mandates on HSB for infertility. Specifically, the rates of HSB for infertility were higher among women residing in states with state-level mandates.

A limitation in this research stems from a data restriction that forced identifying a place-of-residence before or after 2000. To overcome this, multiple analyses, and a nested model comparison were tested to measure the effect of state-level mandates on HSB.

The comparative analysis of the rates of HSB for women residing in states with state-level mandates has not been considered before, and the results provide further detail into the infertility experience for women and their partners.

Citation

Maki Weller, N. (2017), "An Examination of State-Level Mandates for Insurance Coverage on Health-Seeking Behaviors for Infertility", Health and Health Care Concerns Among Women and Racial and Ethnic Minorities (Research in the Sociology of Health Care, Vol. 35), Emerald Publishing Limited, Leeds, pp. 79-95. https://doi.org/10.1108/S0275-495920170000035005