In the United States, women living in urban centers are more likely to be in their reproductive years thantheir rural counterparts.
For many reproductive health indicators, city residents experience worse reproductive health outcomes compared to the national average. AIDS incidence rates in cities are twice the national average. Infant mortality, low birthweight rates, unintended pregnancy, and the percentage of teenage mothers are also higher in large cities, especially among low-income women.
Many of the poor reproductive health indicators are directly correlated to limited access to health care services and information, which is in turn inextricably linked with some of the systemic problems plaguing many urban areas: poverty, racism, shortage of affordable housing, crime, lack of adequate public transportation, and the concentration of environmental pollutants and toxins.
There are many committed, progressive, pro-choice, pro-family planning elected and public health officials who have the political will and influence to drastically improve the health of families living in their municipalities. Even in states with legislatures hostile to addressing reproductive health issues, local legislative leaders are more likely to have the commitment and leadership to address the problems that directly impact the health of their communities.
As hubs of academic medicine with strong public health infrastructures, cities are well positioned to set in motion cutting-edge public health initiatives to address these concerns.
Collaboration between local advocates and public officials provides an opportunity to create new and innovative models of municipal legislation and resolutions that can strengthen the rights of women to access the full range of reproductive health services.
Working locally allows for targeted interventions at the community level to provide resources and support where they are most needed.
At the national level, many lawmakers continue to put politics over science and real public health solutions. The vitriolic, ideological debate at the federal level is often mirrored by state lawmakers, and the resulting gridlock has a direct impact on the resources, information, and services av
ailable to women at the local level.
In this divisive political environment, the need for municipal leaders to come together to collaboratively develop and support a reproductive health agenda has never been greater. Local officials are better poised and motivated to embrace smart, progressive, and creative solutions to address their communities’ reproductive health needs.
There is also a critical role for public health leaders to improve the reproductive health of urban communities. Local Departments of Health are in an ideal position to implement innovative reproductive health policies and programs and effectively collect and analyze data on specific reproductive health indicators by race, ethnicity, socioeconomic status, and geographic location.
With the necessary resources, political support, and strategic partnerships with local community-based organizations, these institutions can play an essential role in protecting and promoting reproductive health.
The main goals of the Urban Initiative include:
- identifying elected leaders and public health officials who embrace a proactive policy agenda to reduce unintended pregnancy and improve the reproductive health of their communities;
- providing a forum for elected leaders and public health officials to share their knowledge, expertise, and experiences;
- supporting a new generation of leaders who can effectively communicate a progressive agenda for reproductive health in their communities;
- establishing a clearinghouse of promising local models of policies and programs that are funded, administered, or legislated at the municipal level fostering collaboration between advocates, elected leaders, and public officials in cities across the nation to create and implement a local Urban Reproductive Health Agenda.
