Report on Women’s Healthcare Access in the U.S. and its Implications for Sustainable Development Goals

Introduction: A Worsening Crisis in Women’s Health

A significant and expanding gap in women’s healthcare access is emerging in the United States, posing a direct threat to the nation’s progress toward key Sustainable Development Goals (SDGs). Recent legislative and judicial actions are compromising the health, well-being, and fundamental rights of women, directly contravening the principles of SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality). This report details the primary drivers of this crisis and analyzes their impact on national health outcomes and SDG targets.

Legislative and Judicial Setbacks to SDG 3 and SDG 5

Recent policy shifts have systematically undermined the framework for women’s healthcare, particularly sexual and reproductive health services, which are critical components of SDG 3 and SDG 5.

• The Dobbs v. Jackson Women’s Health Organization Decision: The revocation of the federal right to abortion has been a central catalyst, enabling state-level restrictions that limit bodily autonomy and access to essential medical care. This directly conflicts with SDG Target 5.6, which calls for universal access to sexual and reproductive health and reproductive rights.
• Defunding of Healthcare Providers: Legislative measures, such as the provision to cut federal Medicaid funding for Planned Parenthood, threaten to close up to 200 clinics and deny care to over one million patients. This action jeopardizes access to a wide range of services essential for achieving SDG 3.
• The Medina v. Planned Parenthood South Atlantic Ruling: This U.S. Supreme Court decision determined that Medicaid patients do not have an inherent right to choose their medical provider if that provider is Planned Parenthood. This ruling disproportionately affects low-income women, exacerbating inequalities and hindering progress toward SDG Target 10.2 (promote universal social inclusion) and SDG Target 3.8 (achieve universal health coverage).

The Healthcare Workforce Crisis and its Impact on SDG 3 and SDG 10

The deteriorating policy landscape is contributing to a severe healthcare workforce shortage, creating “medical deserts” and deepening regional health disparities, which undermines SDG 10 (Reduced Inequalities).

Key Factors:

1. OB-GYN Shortage: The U.S. is projected to have a deficit of over 5,000 OB-GYNs by 2030 due to early retirement and burnout, conditions worsened by restrictive practice environments.
2. Clinician Exodus: In the year following the Dobbs decision, 42% of surveyed clinicians providing abortions in states with severe bans relocated, primarily to states without such restrictions. This migration of medical expertise concentrates resources in some areas while depleting them in others.
3. Impact on Medical Training: Restrictive state laws deter new medical professionals, as many students are unwilling to train or practice in states that limit their ability to provide comprehensive care and curtail their own reproductive rights.

This exodus directly contributes to the formation of medical deserts, particularly in states with restrictive policies. The lack of accessible care in these regions presents a major obstacle to achieving SDG 3 targets for all populations.

Broader Health Consequences and Failure to Meet SDG Targets

The crisis extends beyond abortion access to encompass the full spectrum of women’s health throughout their lifespan. The reduction in healthcare access will lead to a series of negative health outcomes, representing a systemic failure to meet fundamental SDG targets.

Projected Consequences:

• Increased Maternal Mortality: Reduced access to prenatal and emergency obstetric care will worsen maternal death rates, moving the nation further away from SDG Target 3.1 (reduce the global maternal mortality ratio).
• Rise in Non-Communicable Disease Mortality: The closure of clinics limits access to vital screenings for cervical and breast cancer, as well as management for diabetes and cardiovascular disease. This will likely lead to more preventable deaths, contrary to SDG Target 3.4 (reduce premature mortality from non-communicable diseases).
• Neglect of General Women’s Health: Women will face increased suffering from untreated conditions such as endometriosis, fibroids, and infertility, and will lack access to counseling and treatment for menopause.

These outcomes will affect all women, regardless of their personal views on abortion, demonstrating a broad-based regression in public health that undermines the core principle of universal health access embedded in SDG 3.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

This is the most prominent SDG in the article. The entire text focuses on the deteriorating state of women’s healthcare in the United States, including access to reproductive care, cancer screenings, and treatment for chronic diseases. The article explicitly warns, “more of us indeed will die,” directly linking the discussed policies to negative health outcomes.

SDG 5: Gender Equality

The article frames the issue as a targeted attack on women’s rights and autonomy. It states that the U.S. has “entered into an era of state-sanctioned deprivation of women’s bodily autonomy” and that “daughters have fewer freedoms than their mothers and grandmothers.” This highlights a regression in gender equality and the empowerment of women.

SDG 10: Reduced Inequalities

The article points to a growing disparity in healthcare access based on geography and economic status. It describes the emergence of “medical deserts” which are “more prevalent in states with restrictive abortion policies.” It also notes the impact on Medicaid patients, who are losing the right to choose their provider, thus exacerbating inequalities for low-income women.

SDG 16: Peace, Justice and Strong Institutions

The article critiques the role of legal and governmental institutions, including the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, congressional actions to defund Planned Parenthood, and state legislatures enacting restrictive laws. This points to a failure of institutions to uphold established rights and ensure non-discriminatory access to care for all citizens.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.1: By 2030, reduce the global maternal mortality ratio. The article directly addresses this by predicting, “There will be more maternal deaths” as a consequence of reduced healthcare access.
   • Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment. The article warns of “more deaths from cervical and breast cancer” and “more women will die from complications of cardiovascular disease and diabetes” due to the lack of access to screenings and care.
   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services. The core of the article discusses the assault on reproductive care, including abortion, birth control, and testing for STIs, particularly through the defunding of Planned Parenthood.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services. The article highlights the “denial of basic medical care for over one million patients” and the creation of “medical deserts” as direct contradictions to this target.
   • Target 3.c: Substantially increase health financing and the recruitment, development, training and retention of the health workforce. The article details a looming “doctor shortage,” with a projected deficit of “more than 5,000 OB-GYNs nationwide” by 2030 and a mass exodus of clinicians from restrictive states.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights. The article’s central theme is the loss of these rights, citing the revocation of the “federal right to abortion” and the “deprivation of women’s bodily autonomy.”

3. SDG 10: Reduced Inequalities

   • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices. The article describes how new laws and court rulings are creating vastly different health outcomes for women depending on which state they live in, fostering inequality.

4. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.b: Promote and enforce non-discriminatory laws and policies for sustainable development. The article argues that the policies being enacted, such as the bill to defund Planned Parenthood, are discriminatory and harmful to the well-being and health of women.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3 (Good Health and Well-being):

   • Maternal mortality rate: The article explicitly states, “There will be more maternal deaths.”
   • Mortality rate from non-communicable diseases: The text mentions an expected rise in “deaths from cervical and breast cancer” and from “cardiovascular disease and diabetes.”
   • Number of healthcare facilities closed: The article notes that defunding could lead to the “closure of as many as 200 clinics.”
   • Number of patients losing access to care: It is mentioned that the defunding could result in the “denial of basic medical care for over one million patients.”
   • Density of health workers: The article quantifies the shortage of specialists, stating the U.S. can “expect to be down more than 5,000 OB-GYNs nationwide by 2030.”
   • Relocation rate of health professionals: A specific statistic is provided: “42 percent of surveyed clinicians who provided abortions in states with near-total or six-week bans relocated to another state.”

2. For SDG 5 (Gender Equality):

   • Proportion of women of reproductive age who have their need for family planning satisfied with modern methods: The article implies a decrease in this proportion by discussing reduced access to birth control and the closure of clinics like Planned Parenthood.
   • Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care: The article discusses the revocation of the federal right to abortion, indicating a negative change in U.S. law.

3. For SDG 10 (Reduced Inequalities):

   • Geographic disparities in healthcare access: The article directly refers to the emergence of “medical deserts,” which are “more prevalent in states with restrictive abortion policies,” as a clear indicator of geographic inequality.

4. Table of SDGs, Targets, and Indicators

Source: msmagazine.com