Female Infertility and Obesity across the United States—A Geographic Cross-Sectional Analysis

This cross-sectional study investigates a connection between female infertility and obesity across various regions of the United States, utilizing data from the NIH’s “All of Us” Researcher Workbench. Analysis suggested that the Southern region exhibited the highest percentage of concurrently infertile and obese females at 32.3%, in contrast to the lowest in the Western region at 28.7%. The findings underscore the significant regional disparities in obesity-related infertility, particularly in medically underserved areas where healthcare access is limited. The study highlights the urgent need for targeted public health interventions, particularly in the Southern United States, to address the rising prevalence of obesity and its impact on infertility. Further, these results advocate for enhanced public health education and policies aimed at improving healthcare accessibility, with the goal of mitigating the adverse effects of obesity on reproductive health.

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

Impact of Social Determinants of Health on the Choice and Use of Long Acting Reversible Contraceptives

Modern women have increased options for birth control with the development of Long Acting Reversible Contraceptives (LARCs). These methods are reliable, easy to use, and require less daily maintenance while providing contraception for an extended period of time. However, despite the surge of LARCs as contraceptive options, the prevalence of unintended pregnancies is still alarmingly high in the United States. As LARCs are the most effective reversible method of birth control at preventing pregnancy, and therefore the potential social, financial, and medical complications associated, we examined whether social determinants of health play a role in LARC usage. While parity and marriage do not seem to affect LARC utilization, increased research is needed to determine the effects of race. Age can affect the type of LARC implemented, as younger women prefer implants to intrauterine devices (IUDs). Insurance coverage was an apparent influencer of LARC usage, as low out-of-pocket costs translate to increased utilization. This is linked to socioeconomic status (SES), as lower SES is associated with decreased access to healthcare in general. Increased research is needed in order to draw conclusions about the effects of education, intimate partner violence, geographic location, and other SDH on LARC usage.