approaches to medicine in general or contraception in particular. Some bring with them rich traditions of folk medicine (such as reliance on herbal medicines and various folk remedies and use of neighborhood practitioners rather than doctors for health care) that do not always blend easily with U.S.
For example, some immigrants arrive in the United States from countries whose systems of family planning services are arguably better organized than those here and whose range of available contraceptive methods is broader. This cultural and ethnic diversity is reflected in widely varying knowledge about and attitudes toward contraception and fertility control. Moreover, in assessing ethnic, racial, and cultural diversity, it is important to distinguish recent immigrants, such as the majority of Southeast Asians now in the United States, from native-born Americans such as the vast majority of black Americans. For example, Asian/Pacific Islanders include Laotians, Cambodians, Vietnamese, Hawaiians, Filipinos, Samoans, Guamanians, Japanese, Chinese, Koreans, and others as well.
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One school in suburban Virginia claims that there are more than 36 language groups represented in its student population.Įven the terms used to describe the growing diversity of the United States-Asian/Pacific Islander, Middle Eastern, or Hispanic/Latino-fail to capture the full complexity. School districts in some sections of the country already report that their enrolled children represent many different language groups. The full impact of such diversity is not just a promise for the future, however.
Similarly, some projections suggest that non-white individuals will be the majority in as many as 53 of America's largest cities only 5 years from now, by the year 2000 (Nestor, 1991).
population, versus 76 percent in 1990 people of Hispanic origin will be 20 percent of the population in 2050, versus 9 percent in 1990 and the proportion of blacks will grow from 12 to 14 percent over the same interval (Day, 1993). The Bureau of the Census estimates that by the year 2050, non-Hispanic whites will constitute 56 percent of the U.S. The United States is already a diverse mix of cultural, racial, and ethnic groups, and will be even more so in future years. Consideration of them must be part of any serious inquiry into the reasons that lie behind high rates of unintended pregnancy in the United States. Nonetheless, in the aggregate, they help to form the environment in which individual decisions about contraception and sexual activity occur. It is not always clear what the precise relationship is between these factors and the risk of unintended pregnancy. population (including ethnic, cultural, and religious diversity), conflicting views of sexuality and how such views might influence the use of contraception, economic issues, the roles that racism and violence play in various aspects of reproductive life, selected aspects of gender bias that relate to unintended pregnancy, and how organized opposition to abortion might affect access to contraception.
Accordingly, this chapter discusses several socioeconomic and cultural factors that, in varying ways, may affect contraceptive use and therefore unintended pregnancy: the large and increasing diversity of the U.S. It is also consistent with data suggesting that the more favorable rates reported by numerous Western European and other industrialized countries on such maternal and child health measures as infant mortality partly reflect the more generous policies and supports that these countries often provide pregnant women and young families (Miller, 1993). This observation is consistent with a number of studies-often called a real research-showing that various community attributes, as distinct from individual characteristics, are associated with the likelihood of using contraception (see, for example, Mosher and McNally, 1991 Singh, 1986 Tanfer and Horn, 1985). Contraceptive knowledge and access ( Chapter 5) are undoubtedly shaped by the surrounding socioeconomic and cultural environment, as are personal attitudes and feelings about contraception ( Chapter 6).
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