Seeking solutions: the campaign for reproductive justice for Latinas in California.

ACCORDING TO THE 2000 United States Census, Latinos, at almost 11 million, compose 32 percent of California's population. Among the Latino population, 51 percent are male and 49 percent are female. Latinas are relatively young, with a median age of 25.4. Indeed, 49 percent of Latinas are age 24 or younger. Latinas, of any race, compose 32 percent of all women in California, for a total of 5.4 million Latinas in the state.

The Public Policy Institute of California estimates that in 2025, almost half of all California's residents will be Latino, amounting to over 22 million Latinos in the state. The number of Latinas in California will double, to 10.8 million. Immigration will account for only 30 percent of this growth, with a majority of the growth due to U.S. births, many of which will produce second-generation Californians with at least one foreign-born parent.

SOCIOECONOMIC STATUS AND HEALTH OUTCOMES

Health experts consistently cite poverty and lack of access to health insurance as critical factors affecting Latinas' health and that of Latino youth. These issues are closely interconnected with Californian Latinas' socioeconomic status and educational attainment levels, and those of the Latino community as a whole.

For example, Latinas participate actively in California's labor force. According to the California Employment Development Department, of the 3.6 million Latinas over the age of 16, 52 percent are in the labor force. Of these nearly 2 million Latina workers, many are concentrated in lower-paying administrative support and service jobs, as well as those that present occupational and environmental hazards. A recent report found that while women have lower median earnings than men, women of color have lower median earnings than white women, and Latinas have the lowest median earnings.

Despite the large number of Latinas and Latinos who participate in the labor force, many struggle with poverty. According to the Census Bureau, a family of four that earns less than $18,307 lives in poverty. Almost one-quarter (2.4 million) of all Latinos in California are below that line. Eighteen percent of Latinas live in poverty, compared with 8.3 percent of white women.

Related to socioeconomic status and earnings, educational attainment also has been found to play a critical role in women's health outcomes. For example, a recent study by the Kaiser Family Foundation addressing disparities in maternal and infant health in California found that women who have not finished high school are three times as likely as women who have completed college to lack prenatal care during the first three months of pregnancy. In California, Latinas' high school completion rate is 53.5 percent, compared with 93-7 percent for white women and 81.1 percent for females overall. As such, equal access to educational

opportunities, including higher education, for Latina girls and young women is important to achieve positive health outcomes.

It is clear that Latinas' health--and reproductive health in particular--cannot be viewed in isolation. For example, Latinas' economic security; access to equal educational opportunities; and freedom from discrimination, violence and environmental hazards in their communities, educational institutions and workplaces have a profound effect on Latinas' abilities to make informed choices about their health and future lives.

HEALTH DISPARITIES 

An important element of reproductive health for Latinas is access to health services. Having access to basic health services and health insurance plays a significant role in women's reproductive health. This is especially critical for Latinas, who disproportionately lack access to health insurance in California.

Latinas continue to lack access to basic health services. According to the 2005 California Health Interview Survey, Latinas have the greatest likelihood of being uninsured among all groups of women in California. Over 20 percent of Latina women are uninsured, totaling over 1 million women.

Lack of access to health care is reflected in California Latinas' reproductive and sexual health disparities. For example, Latinas accounted for 33.2 percent of new HIV/AIDS cases among California women in 2004.

Since the early 1990s, California's teen birthrates have been declining. From 1991 to 2001, the rate declined from 75 (per 1,000 teen girls) to 45.2. Yet the birthrate of Latina teens in California (75.3) is three times as high as that of white teens (22.4). One of the best predictors of teen birthrates is poverty. The Public Health Institute has found that an increase in the poverty rate in one year tends to be followed by a higher teen birthrate the following year. The teen birthrates in the Latino community continue to be vulnerable, as the poverty rates in California, described above, are significant.

About one in three women in the United States will have had an abortion by age 45. In California, almost 900,000 of the 7.6 million women of reproductive age became pregnant in 2000. Of these pregnancies, 59 percent resulted in live births, and 26 percent in induced abortion. In California, the abortion rate is 31.2 per 1,000 women of reproductive age, compared with the national rate of 21.3.

Among Latinas in the United States, the numbers are similar. According to the Guttmacher Institute, Latinas account for 20 percent of women having abortions in the United States. Among Latinas ages 15-44, 25 percent of all pregnancies end in abortion. Unfortunately, as there is very little research on Latinas and abortion generally, there is a dearth of data on Latinas' abortion rates in California.

Overall access to abortion services is declining because of a decrease in providers. California had 400 abortion providers in 2000, a decrease of 19 percent since 1996. Forty-one percent of California counties do not have abortion providers. This creates additional barriers in rural communities and for low-income women, as almost 20 percent of women in California have to travel more than 50 miles to receive care.

The most prevalent reproductive health cancers in women are breast and cervical cancer. For both of these cancers, regular screening is the most effective way to prevent and diagnose early-stage cancer. Because they lack health insurance, Latinas often do not have access to early and regular screening. Latinas have the highest risk of developing cervical cancer in California and account for one-third of diagnosed invasive cervical cancer cases in the state. In 2003, breast cancer was the leading cause of cancer death among Latinas.

LATINO SUPPORT FOR REPRODUCTIVE HEALTH ISSUES

Health disparities between Latinas and others call for urgent policy action, coupled with community support. Fortunately, recent public opinion demonstrates opportunities to work on these issues in the Latino community.

Contrary to common public perception, recent public opinion research shows that Latinas and Latinos overwhelmingly demonstrate strong interest in reproductive and sexual health issues. In particular, they have expressed the need for additional information about reproductive and sexual health--among both adults and adolescents-and further outreach about access to reproductive health services. These messages are consistent in larger studies and community-based participatory research conducted by Latina reproductive health advocates. They also reflect the experiences of those working with the community.

BIRTH CONTROL AND SEXUAL EDUCATION

According to a survey by the Public Policy Institute of California, Californians overwhelmingly agree that access to contraception is very important (71 percent) for reducing the number of unintended pregnancies. Latinos and blacks were more likely than other groups to respond that way (79 percent and 74 percent, respectively, compared with 53 percent for Asians and 69 percent for whites).

While most Californians believe access to birth control is important, only 38 percent of Latinos said they were highly aware about issues regarding birth control methods and contraceptives. Moreover, while 85 percent of adults in California say they have heard of emergency contraceptive pills, only 23 percent of Latinos, 21 percent of blacks, 20 percent of Asians, and 15 percent of whites know the pills are available from pharmacists without prescriptions. Fifty percent of Latinos favor women's access to emergency contraception without doctor's prescriptions.

Another survey found that Latinas care about and want more access to sexuality education and reproductive health services. A majority of respondents said information on all methods of birth control should be available to teenagers under the age of 18. Seventy percent of Latinas strongly agreed with this statement, and 14 percent somewhat agreed.

Latinas' responses debunked several myths that are common in the Latino community concerning the influence of religion and cultural norms surrounding contraception. Sixty-four percent of U.S.-born Latinas strongly disagreed that the use of natural birth control, or the rhythm method, was the only acceptable method of birth control. Thirty-three percent of foreign-born respondents strongly disagreed.

ABORTION

In the PPIC survey, 60 percent of Latinos said they would not like to see the Supreme Court completely overturn the Roe v. Wade decision upholding the constitutional right to abortion. Contrary to common public perception, only 50 percent of Latinos reported having religious or moral objections to abortion.

There are several reasons why Latinas would not like to see Roe v. Wade over-turned. Seventy-four percent supported legal abortion when women's health was at risk, 66 percent when there was evidence of serious birth defects, 58 percent when pregnancy resulted from rape or incest, 66 percent when pregnancy would cause teens to drop out of school, and 66 when mothers could not afford more children.

ARE CALIFORNIA'S REPRODUCTIVE RIGHTS POLICY WINS REACHING LATINAS?

California has emerged as a national leader in reproductive health and rights policy. The California Constitution broadly protects privacy rights, affecting the rights to reproductive health services for women and adolescents in the state. California's policy landscape has reflected strong support for promoting access to comprehensive reproductive health services and sexuality education through state-sponsored policies, programs and services. California has enacted legislation affirming the constitutionally protected right to reproductive choice; providing pharmacy and emergency room access to emergency contraception; promoting contraceptive equity in employer-based health coverage; and promoting comprehensive sexuality education in public schools.

Despite these important legal and policy developments, access to comprehensive, confidential and culturally and linguistically appropriate reproductive and sexuality health information and services continues to be critically lacking for the most disenfranchised women and youth in California, including low-income, young, rural and immigrant Latinas. In other words, a disconnect exists between California's reproductive health and rights policy wins and Latinas' reproductive health problems and access barriers. Latinas share this lack of access and reproductive oppression with other low-income women of color, young women, immigrant women and other groups of disenfranchised women and youth in California.

As such, women and communities subject to reproductive oppression and excluded from California's reproductive rights gains are working in solidarity to build a new reproductive justice movement. This includes adopting a Latina reproductive justice framework to address reproductive health disparities and promote systemic change. In order to promote Latinas' reproductive justice and further Latino communities' health, progress and opportunities, it is vital to introduce systemic policy changes that address Latinas' intersecting social, economic and health concerns.

Latinas have the power to identify policy priorities that advance reproductive justice and play an active role in creating positive policy change. In doing so, Latina leaders can work to re-connect California's policy wins to Latinas and their families and communities, in alliance with low-income women of color, immigrant women, youth and other disenfranchised groups.

Resources

National Latina Institute for Reproductive Health

50 Broad Street, Suite 1825

New York, NY 10004

[phone]

www.latinainstitute.org

LLEGO--The National Latina/o Lesbian, Gay Bisexual & Transgender Organization

1420 K Street, NW, Suite 200

Washington, DC 20005

[phone]

National Council of La Raza 

Raul Yzaguirre Building

1126 16th Street, NW

Washington, DC 20036

[phone]

www.nclr.org

National Latina Health Network

2001 Wisconsin Avenue, NW

Suite 340

Washington, DC 20007

[phone]

www.nlhn.net

Cancion Latina

c/o SisterSong Women of Color Reproductive Health Collective

P.O. Box 311020

Atlanta, GA 31131

[phone]

www.SisterSong.net

The National Alliance for Hispanic Health

1501 16th Street NW

Washington, DC 20036

[phone]

www.hispanichealth.org

Hispanas Organized for Political Equality (HOPE)

634 S. Spring Street, Suite 920

Los Angeles, CA 90014

[phone]

www.latinas.org

California Latinas for Reproductive Justice

Post Office Box 412225, Los Angeles, California 90041 * 213.270.5258

California Latinas for Reproductive Justice, founded in 2004, is a California-based policy and advocacy organization whose mission is to advance Latinas' reproductive health and rights within a social justice and human rights framework. CLRJ works to ensure that policy developments are reflective of the priority needs of Latinas, their families and their communities. CLRJ advances its mission through targeted, culturally based policy advocacy, alliance-building, community education and strategic communications strategies that further its core policy goals and are specifically geared toward educating and mobilizing Latino constituents, both on the policy level and within target Latino communities.

For more information: www.clrj.org.

ROCIO CORDOBA is the executive director of California Latinas for Reproductive Justice, www.clrj.org. A full set of references and more information about CLRJ is available at www.conscience-magazine.org.