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Mental Health

Post Dobbs: Distance to abortion facilities and depressive symptoms among racially/ethnically minoritized women of reproductive age Abhery Das* Abhery Das Allison Stolte Samantha Gailey

On June 24, 2022, the US Supreme Court’s decision on Dobbs v. Jackson Women’s Health transformed the landscape of abortion access in the US by granting states the power to ban abortion. In the following months, several states implemented restrictive abortion laws that limited women’s fertility decisions and hindered their access to comprehensive reproductive care. The symbolic dis/empowerment framework suggests that these new sociopolitical contexts may disempower women in ways that harm their psychological well-being. Indeed, one study reports greater mental distress among women of reproductive age following the Dobbs decision. The psychological burdens of Dobbs, however, likely manifest heterogeneously. Previous studies find that racially/ethnically minoritized women experienced disproportionate harms from pre-Dobbs restrictive reproductive health laws. More recently, many abortion-related lawsuits have targeted racially/ethnically minoritized women, which may heighten feelings of disempowerment among these groups. We test whether state-level disempowerment related to women’s reproductive health, proxied as distance to abortion facilities, coincide with greater depressive symptoms among racially/ethnically minoritized women of reproductive age after the Dobbs decision. As our exposure, we utilize quartiles of within-state average driving distance (miles) to abortion facilities, captured at the county-level. For our outcome, we use the Patient Health Questionnaire-2, a clinically valid measure of depressive symptoms among 49,361 racial/ethnic minoritized women of reproductive age (18-49). We use biweekly surveys (repeat cross-section) from August 2020 – July 2023 from the nationally representative Census Household Pulse Survey. We find that women of color the furthest away from abortion facilities (quartile 4; >103 miles) show slightly greater depressive symptoms (Coeff: 0.13; SE: 0.04; p=0.003) than women of color closer to abortion facilities (quartile 1; <28 miles) after the Dobbs decision. Increased distance to abortion facilities may reflect feelings of restricted bodily autonomy and overall disempowerment that hinder the mental health of women of color at reproductive age.