P2.A015: Prevalence of Period Poverty in a Pediatric Emergency Department

Background: Period poverty, defined as insufficient access to menstrual hygiene products and menstrual education, impacts 11.9 million females, including 25% of adolescents in the United States. Period poverty may contribute to health issues, such as urinary tract infections and bacterial vaginosis, as well as absences from school/work, which may disrupt education. The objective of this study was to measure the prevalence of period poverty in our pediatric emergency department (ED) and to evaluate the association between period poverty and Child Opportunity Index (COI).

Methods: This was a secondary analysis of data collected via the Teen Heath Screen, an adolescent (ages 13-21 years)-completed electronic survey designed to improve sexually transmitted infection detection in the ED. Participants who responded yes to either of the following questions were coded as experiencing period poverty: 1) “If you have had a period during the past 12 months, did you ever have to use something other than a pad or tampon, such as cloths, rags, tissues, or toilet paper or if you have had a period during the past 12 months?” or 2) “Did you need menstrual products but not have the money to buy them?”. Home address was geocoded and linked with COI, a multidimensional neighborhood measure of childhood opportunity based on census tract. The prevalence of period poverty was calculated, and multivariable logistic regression models were used to measure the association of period poverty with COI. Secondary analyses included measuring association of period poverty with insurance status, and race and ethnicity.

Results: There are currently 678 participants meeting inclusion criteria in this ongoing study. Participants had a mean age of 15.9 (+/- 2.1) years and were predominantly non-Hispanic (NH) Black (n=479, 70.6%), publicly insured (494, 72.9%), and living in an area with very low COI (n=507, 74.8%). , More than one-third of all participants (n=236; 34.8%) experienced period poverty during the past 12 months. In separate multivariable models adjusted for age, there were no difference in prevalence of period poverty by COI, insurance status, or race and ethnicity. (Table 1)

Conclusion: One in three study participants reported experiencing period poverty in the past 12 months, with no differences by COI, insurance status, or race and ethnicity. Further research is needed to understand the true breadth of the period poverty among adolescents. To address this inequity, the provision of free menstrual hygiene products should be available in ED bathrooms and during all health care visits. Further, given the widespread prevalence of this need, policy initiatives to make menstrual hygiene products more affordable (e.g. removing tax on menstrual products) and accessible (e.g. providing free menstrual hygiene products in public spaces like schools) should be undertaken.