The Washington Post - USA (2022-05-08)

SUNDAY, MAY 8 , 2022. THE WASHINGTON POST EZ RE A

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PUBLIC HEALTH LEADERS URGE

SCOTUS TO UPHOLD ROE V. WADE

Dear Supreme Court of the United States,

As public health professionals, we urge the Supreme Court of the United States (SCOTUS) to uphold Roe v. Wade. Overturning Roe v. Wade will

have profound public health consequences. If SCOTUS allows states to ban abortions, abortions will not stop. Unsafe abortion will simply increase,

harming more people – primarily Black women and girls.

If SCOTUS overturns Roe, people – mostly women and girls – will be hurt and some may even die in the U.S. from unsafe abortions.

Despite public support for abortions and overwhelming evidence that access to legal, safe abortion services saves lives, policymakers opposed to

bodily autonomy have pushed laws and regulations restricting or banning abortion, risking the sexual and reproductive health of millions. Forcing

people to carry an unwanted pregnancy to term puts their physical and mental health at risk. The mortality rate associated with childbirth in the U.S.

is 14 times higher than that of legal induced abortion. Each year, around 60,000 women in the U.S. experience severe maternal morbidity –

significant short- or long-term health consequences from labor and delivery – and the rate is steadily increasing. Reversing Roe v. Wade will worsen

these outcomes. Research suggests banning abortion in the U.S. could lead to a 2 1% increase in pregnancy-related deaths.

Legal abortion is safe, effective and an essential component of healthcare. In a comprehensive report, the National Academies of Science,

Engineering, and Medicine stated that the “clinical evidence clearly shows that legal abortions in the U.S. – whether by medication, aspiration, D&E

[dilation and evacuation], or induction – are safe and effective.”

Removing access to legal abortion will set the U.S. even further back on maternal health outcomes and will exacerbate health disparities.

Despite spending more on healthcare per capita than any other country, the U.S. has the highest maternal mortality rate of comparable countries –

double the rate of most high-income countries. The CDC’s 2020 data show a 36.8% increase in U.S. maternal mortality in just two years. Maternal

health outcomes are the worst for women of color and people living in poverty – groups with the least access to reproductive healthcare. Women of

color and uninsured women are significantly less likely to receive sexual and reproductive health services than white women and privately-insured

women. Black women experience more maternal health complications than white women, are twice as likely to experience a life-threatening

complication of pregnancy or delivery (a “near miss”), and are nearly three times more likely to die from pregnancy-related causes.

Reversing Roe will put women and girls who experience physical and sexual violence at further risk. Women who are denied abortions are

more likely to have ongoing contact with a violent partner. Abuse can also increase a person’s risk for an unintended pregnancy, just as unintended

pregnancy can put a person at greater risk of abuse. Around one in four women in the U.S. experience intimate partner violence in their lifetimes, and

some forms of this abuse, including sexual violence, place women at risk of unintended pregnancy. Denying any person an abortion keeps people in

poverty, makes them less likely to pursue higher education, and puts their health at risk. For those experiencing intimate partner violence, these

factors make it even more difficult to escape their abusers.

People living in states where abortion is likely to be highly restricted or banned if Roe is overturned will face increased barriers to

accessing time-sensitive abortion care. Travel distance is a key determinant of abortion care access in the U.S. Many abortion patients are forced

to travel across state lines, with one in five patients traveling more than 50 miles one-way to an abortion facility. A reversal of Roe is predicted to

increase average travel distance by 249 miles for residents of affected counties. Traveling out of state to receive an abortion can result in delays that

force people to have the abortion later in pregnancy, thereby increasing risk of complications, or prevents them from obtaining an abortion altogether.

To the detriment of public health, if Roe is overturned many states will criminalize those who aid, access, or perform abortions. Eighteen

states already have criminal laws that allow for prosecution of pregnant people or their healthcare providers. These laws will be enforceable if Roe

falls. Criminalizing abortion could result in the use of increased police powers of investigation and surveillance and mass incarceration. The burden

will not be evenly shared: Black Americans are incarcerated in state prisons at five times the rate of white Americans. This will invariably spill over

into abortion-related prosecutions. Research shows Black women are more likely to be arrested, reported to authorities, and subjected to felony

charges related to their pregnancies and pregnancy outcomes than white women.

As public health experts, we urge SCOTUS to consider science and public welfare in affirming the constitutional protection for abortion.

Terry McGovern, JD, Harriett and Robert H.

Heilbrunn Professor and Chair, Heilbrunn

Department of Population and Family Health,

Columbia University Mailman School of

Public Health

Linda P. Fried, MD, MPH, Dean and DeLamar

Professor of Public Health, Columbia University

Mailman School of Public Health

Sonia Alemagno, PhD, Dean, Kent State

University College of Public Health

Craig H. Blakely, PhD, MPH, Professor and

Dean, University of Louisville School of Public

Health and Information Sciences

Bernadette Boden-Albala, DrPH, MPH,

Director and Founding Dean, University of

California, Irvine Program in Public Health in

the Susan and Henry Samueli College of

Health Sciences

DuBois Bowman, PhD, Dean, University of

Michigan School of Public Health

Ron Brookmeyer, PhD, Dean and

Distinguished Professor of Biostatistics,

University of California, Los Angeles Fielding

School of Public Health

Thomas Chandler, PhD, MSc, Professor and

Dean, University of South Carolina Arnold

School of Public Health

Marsha Davis, PhD, Dean, University of

Georgia College of Public Health

Ayman El-Mohandes, MBBCh, MD, MPH,

Dean, City University of New York Graduate

School of Public Health and Health Policy

Amy L. Fairchild, PhD, MPH, Dean and

Professor, The Ohio State University College

of Public Health

Dani Fallin, PhD, Incoming Dean, Emory

Rollins School of Public Health

Sandro Galea, MD, MPH, DrPH, Dean,

Boston University School of Public Health

Wayne H. Giles, MD, MS, Dean, University

of Illinois at Chicago School of Public Health

Perry N. Halkitis, PhD, MS, MPH, Dean and

Professor of Biostatistics and Urban-Global

Public Health, Rutgers School of Public Health

Cheryl Healton, DrPH, MPA, Dean, New York

University School of Global Public Health

Thomas LaVeist, PhD, Dean and

Weatherhead Presidential Chair, Tulane

School of Public Health and Tropical Medicine

Michael C. Lu, MD, MS, MPH, Dean,

University of California, Berkeley School of

Public Health

Boris Lushniak, MD, MPH, Dean and

Professor, University of Maryland School of

Public Health

Ellen J. MacKenzie, PhD, Dean and

Bloomberg Distinguished Professor, Johns

Hopkins Bloomberg School of Public Health

Rodrigo Reis, PhD, Interim Co-Dean,

Washington University in St. Louis Brown

School

Barbara K. Rimer, DrPH, MPH, Dean and

Alumni Distinguished Professor, University of

North Carolina Gillings School of Global Public

Health

Jonathan M. Samet, MD, MS, Dean and

Professor, Colorado School of Public Health

Tetine Sentell, PhD, Interim Dean, University

of Hawai'i at Mānoa Thompson School of

Social Work & Public Health

Laura Siminoff, PhD, Dean and Laura H.

Carnell Professor of Public Health, Temple

University College of Public Health

Michelle A. Williams, SM, ScD, Dean of the

Faculty, Harvard T.H. Chan School of Public

Health

Find the full list of signatories at: bit.ly/upholdroe

Institutional affiliation is provided for identification purposes only and does not constitute institutional endorsement.

Contact: [email protected]