American Journal of Public Health Links Food Insecurity to Choice of Telehealth Abortion

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Individuals seeking abortion face considerable challenges including high cost, logistical difficulties such as travel and dependent care, and fear of stigma. In recent times, access to care has improved through telehealth abortion-related medical care via video consultations, phone calls, and delivers medication through the mail, along with pre-abortion counseling. This increasingly utilized care option is patient-centered and comparable as safe and effective as in-person care. However, what factors guide patient selection of telehealth abortion remains uncertain. 

In a recent study, Dr. Courtney E. Williams, Population Research Center, The University of Texas at Austin, United States, collaborated with her institutional colleagues to study whether reasons for choosing telehealth abortion differed in low-income settings. This study was made available online on April 08, 2026, and was published in Volume 116, Issue 5 of the AJPH on May 01, 2026.

“Given the dearth of empirical work in this field, our study addresses a notable shortcoming in the public health literature, refines the understanding of economic disparities in healthcare and expands knowledge on reproductive decision-making,” elaborates Dr. Williams. The researchers analyzed electronic medical records and survey responses from 1,726 participants in the California Home Abortion by Telehealth Study who received telehealth abortion care. Participants were stratified by food insecurity status to report the reasons for their choice of abortion care.

The study reveals that among individuals who experienced food insecurity, telehealth abortion was preferred because it is less costly, avoids secondary expenses such as logistics cost, and mitigates concerns related to judgment and discrimination at an in-person clinic. 

The cost, confidentiality, comfort, and privacy offered by telehealth abortion is appealing to a wider population regardless of their food insecurity status. Emphasizing this broader impact, Dr. Williams says, “Consider that more than 50% of individuals in food-secure households in our study utilized telehealth because of its lower cost.”

The study also shows that individuals experiencing food insecurity are less likely to choose telehealth abortion because of faster access and convenience. One major reason for preferring telehealth abortion is the financial support it provides. Furthermore, if months of food insecurity and structural barriers such as accessibility to healthcare are combined, individuals might feel less active to opt for telehealth abortion care services.

“People experiencing food insecurity likely garner the greatest economic benefit from telehealth abortion, but we suggest that telehealth’s affordability is attractive to a large swath of individuals,” shares Dr. Williams.

In conclusion, when seeking an abortion, food insecurity tied to economic constraints and fear of stigmatization influences decisions relevant to abortion care preferences. Additionally, it is essential to address the economic inequalities and ensure equitable access to healthcare services, thereby upholding the fundamental reproductive rights. 

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The American Public Health Association champions optimal, equitable health and well-being for all. With our broad-based member community and 150-year perspective, we influence federal policy to improve the public’s health. Learn more at www.apha.org.

About The University of Texas at Austin, United States

The University of Texas at Austin is a premier public research university comprising 18 colleges and schools, with a community of approximately 55,000 students, 4,600 faculty members, and 15,000 staff, along with a strong portfolio of nationally recognized programs. The University promotes arts, strengthens the state's economy, serves communities through public programs, and contributes through a wide range of public service initiatives. It also strives to build relationships with industrialists that help secure critical resources and philanthropic support to advance student recruitment, drive cutting-edge research, and enhance academic experiences.

https://www.utexas.edu/about-texas

About Dr. Courtney E. Williams from The University of Texas at Austin, United States

Dr. Courtney E. Williams is a Provost Early-Career Postdoctoral Fellow at The University of Texas at Austin. She has obtained her PhD in Sociology from Louisiana State University. Her research interests lie around understanding and improving maternal, reproductive, and family health. Also, she incorporates intersectional and reproductive justice approach to investigate health equity topics such as heterogeneity in gestational and childbearing outcomes and the effect of sociopolitical factors on reproductive health. She has published more than 5 articles.

Funding information

This research was supported by the BaSe Family Fund, Erik E. and Edith H. Bergstrom Foundation, Isabel Allende Foundation, Jess Jacobs, Kahle/Austin Foundation, Lisa and Douglas Goldman Fund, Preston-Werner Ventures, and a Resource Allocation Program award from the University of California, San Francisco National Center of Excellence in Women’s Health. Courtney E. Williams was partially supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development via the Population Research Center at the University of Texas at Austin (grant P2CHD042849 and grant T32HD007081, Training Program in Population Studies). Leah R. Koenig was funded in part by a training grant from the National Institute of Child Health and Human Development of the National Institutes of Health (NIH; award F31HD111277) for the duration of the study. Ushma D. Upadhyay’s time was funded in part by the National Institute of Child Health and Human Development, NIH (grant R01HD110659).