The independent source for health policy research, polling, and news.
This paper analyzes changes in insurance coverage that have occurred at the national level between 1988 and 1994.
Nationwide surveys have explored public opinion on these issues, but few surveys have measured the public’s knowledge of unplanned pregnancy, abortion, contraceptive methods and other related topics. The Kaiser Family Foundation commissioned a survey of Americans to identify where the gaps and misperceptions exist in the public’s knowledge of reproductive health issues, in an effort to help dispel the myths and provide Americans with the facts. The national household survey of 2,002 Americans was designed and analyzed by the Kaiser Family Foundation and Louis Harris and Associates, Inc. and conducted by Louis Harris and Associates, Inc.
G. Emergency Contraceptive Pills, or Morning-After Pills
G1. If a woman has just had sex and thinks she might become pregnant, is there anything that she could do in the next few days to prevent pregnancy, or not?
Asked only in the U.S. USA18+ Yes, there is something 36% No, there is not anything 47% Too late to prevent pregnancy (Vol.) 1% Not sure/Refused 17% G2. Have you ever heard of morning-after pills, also called emergency contraceptive pills, or not?
USA18+ USA18-44 CAN18-44 NETH18-44 Yes, have heard of it 54% 53% 71% 96% No, have not heard of it 45% 47% 28% 4% Not sure/Refused * 1% * * G3. How soon after sexual intercourse do morning-after pills have to be taken — immediately, within 12 hours, within 24 hours, within 72 hours, or within one week?
Based on those who have heard of emergency contraceptive pills.
USA18+ USA18-44 CAN18-44 NETH18-44 Immediately 10% 10% 9% 4% Within 12 hours 31% 28% 30% 34% Within 24 hours 28% 32% 36% 49% Within 72 hours 9% 12% 11% 6% Within one week 5% 6% * * Not sure/Refused 16% 12% 13% 6% G4. (Ask Females: Have you/ Ask Males: Has your current or most recent partner) ever usedmorning-after pills, or not?
Based on those who have heard of emergency contraceptive pills.
USA18+ USA18-44 CAN18-44 NETH18-44 Yes, have taken 1% 2% 9% 11% No, have not taken 98% 98% 86% 82% Not sure/Refused 1% 1% 5% 7% G5. Morning-after pills are a particular kind of birth control pills that are taken after sexual intercourse. If several of the pills are taken at the same time within 72 hours of sex, they may reduce the chance ofpregnancy by up to 75%.
From what you know about morning-after pills, would you say (you/your current or recent partner) would be very likely, somewhat likely, or not at all likely to take them if you had unprotected sex and wanted to prevent pregnancy?
USA18+ USA18-44 CAN18-44 NETH18-44 Very likely 23% 21% 19% 33% Somewhat likely 20% 24% 23% 17% Not at all likely 47% 52% 47% 31% Not applic. (Vol.) 7% 3% 7% 11% Not sure/Refused 3% 1% 5% 9% G6. Do you think morning-after pills should be widely available, like condoms or tightly controlled like drugs that require a prescription from you doctor?
USA18+ USA18-44 CAN18-44 NETH18-44 Widely available 37% 33% 27% 26% Tightly controlled 58% 64% 64% 71% Not sure/Refused 5% 3% 9% 3% G7. Would a method of birth control that is taken soon after intercourse, such as morning-after pills, pose ethical concerns for you, or not?
USA18+ USA18-44 CAN18-44 NETH18-44 Yes, would pose concerns 36% 43% 31% 21% No, would not 61% 55% 65% 74% Not sure/Refused 3% 2% 5% 4% H. Abortion
H1. Of every 100 pregnancies in the United States, how many do you feel end in abortion?
Asked only in the U.S.
USA18+ Mean: 35 pregnancies Not sure/Refused 5% H2. Do you feel that the number of abortions per every 100 women in the United States is increasing, decreasing, or staying about the same each year?
Asked only in the U.S. USA18+ Increasing 49% Decreasing 8% Staying about the same 41% Not sure/Refused 2% H3. Of every 100 abortions that occur in the United States, how many do you feel occur among (Read each item — Do not rotate)?
Asked only in the U.S.
USA18+ Mean Not sure/Refused a. Teenagers 49 pregnancies 4% b. Lower income women 46 4% c. Minority women 42 6% H4. Of all women between the ages of 12 and 50, what percentage do you feel has had an abortion?
Asked only in the U.S. USA18+ Mean: 31% Not sure/Refused 7% H5. Is the percentage of women in the United States who have had an abortion higher, lower, or about the same as the percentage of women who have had an abortion in other developed countries like Canada, Great Britain or Germany?
USA18+ USA18-44 CAN18-44 NETH18-44 Higher in the U.S. 49% 57% 10% 16% Lower in the U.S. 16% 14% 43% 67% About the same 28% 24% 32% 7% Not sure/Refused 6% 5% 15% 10% I. Factuals
Now, I have just a few factual questions for the purpose of classification.
I1. Are you single, married, living as a couple with someone, widowed, separated, or divorced?
USA18+ USA18-44 CAN18-44 NETH18-44 Single 19% 29% 33% 24% Married 56% 53% 49% 55% Living as a couple 6% 9% 13% 17% Widowed 1% 1% 1% * Separated 2% 2% 2% * Divorced 7% 3% 3% 3% Not sure/Refused * * * * I2. Are you covered by any form of health insurance including Medicaid or Medicare, or not?
Asked only in the U.S.
USA18+ Yes 84% No 16% Not sure/Refused * I3. What is the highest level of school you have completed or the highest degree you have received? (Probe: If respondent says just “High School:” What was the highest grade youcompleted? If 12th Grade, code “Graduate.” If 11th Grade or less, code “Less Than.”)
The U.S. and Canada: USA18+ USA18-44 CAN18-44 Less than high school (grades 1-11, grade 12 but no diploma) 12% 7% 16% High school graduate or equivalent (e.g., GED) 42% 44% 26% Some college but no degree 25% 28% 20% College graduate 14% 15% 24% Postgraduate 6% 6% 15% Not sure/Refused * * 8% The Netherlands:
NETH18-44 Primary school 3% Lower technical and vocational education 16% Lower secondary school 14% Middle technical and vocational education 29% Higher secondary school 10% Higher technical and vocational education 21% University 7% Not sure/Refused * I4. Are you of Hispanic or Latino origin or descent, or not?
Asked only in the U.S.
USA18+ USA18-44 Yes 8% 10% No 90% 88% Not sure/Refused 2% 1% I5. Do you consider yourself white, (Rotate: Black or African-American), Asian or Pacific Islander, Native American or some other race?
Asked only in the U.S.
USA18+ USA18-44 White 80% 77% Black or African-American 12% 13% Asian or Pacific Islander 1% 2% Native American 2% 2% Other race 4% 5% Not sure/Refused 1% 1% I6. Which of the following income categories best describes your total 1993 household income? Was it (read list)?
USA18+ USA18-44 CAN18-44 NETH18-44 $7,500 or less 9% 7% 4% 7% $7,501 to $15,000 11% 10% 6% 8% $15,001 to $25,000 17% 18% 14% 27% $25,001 to $35,000 17% 17% 15% 21% $35,001 to $50,000 19% 21% 18% 7% $50,001 to $75,000 12% 13% 21% 4% $75,001 to $100,000 5% 5% 7% * $100,001 to $125,000 2% 2% 3% * Over $125,000 2% 3% 3% * Not sure/Refused 6% 4% 9% 25% I7. Did you vote in the 1992 presidential election, when about half of the American public voted, or not?
Asked only in the U.S.
USA18+ Yes 71% No 29% Not sure/Refused * I7a. Did you vote for George Bush, Bill Clinton, or Ross Perot?
Based on those who voted in the 1992 presidential election. Asked only in the U.S.
USA18+ George Bush 38% Bill Clinton 41% Ross Perot 14% Other 1% Not sure/Refused 5% I8. How frequently do you attend religious services? Would you say at least once a week, at least once a month, a few times a year, or never?
USA18+ USA18-44 CAN18-44 NETH18-44 At least once a week 37% 30% 18% 10% At least once a month 16% 18% 14% 10% A few times a year 28% 33% 38% 24% Never 18% 19% 30% 55% Not sure/Refused 1% * 1% 1% I9. Language interview was conducted in.
USA18+ USA18-44 CAN18-44 NETH18-44 English 99% 98% 71% * Spanish 1% 2% * * French * * 29% * Dutch * * * 100%
Surveys on Public Knowledge and Attitudes on Contraception and Unplanned Pregnancy:Survey Part One Part Two Part Three
To gather early insights and timely information for state and federal policymakers concerning how the movement to managed care is affecting the poor and their access to care, the Henry J. Kaiser Family Foundation and The Commonwealth Fund are jointly sponsoring case studies and population surveys in California, Minnesota, New York, Oregon, and Tennessee. This case study describes the first year’s experience of Oregon’s Initiative, the Oregon Health Plan (OHP). It is designed to furnish insights on access issues related to the movement to managed care under the OHP.
To gather early insights and timely information for state and federal policymakers concerning how the movement to managed care is affecting the poor and their access to care, the Henry J. Kaiser Family Foundation and The Commonwealth Fund are jointly sponsoring case studies and population surveys in California, Minnesota, New York, Oregon, and Tennessee. This case study describes the first year’s experience of Tennessee’s initiative, TennCare. The TennCare experience provides early insights into the issues that states will face as they move to enroll more of their low-income populations into managed care arrangements.
Report (.pdf)
Attitudes And Practices With Regard To Abortion
Conducted by Fact Finders, Inc. of Albany, New York, this 1995 survey on contraception and unplanned pregnancy concerned Obstetrician/Gynecologists’ attitudes and practices regarding the issues.
This paper analyzes the rapid growth in the Medicaid program during the 1988 – 1992 period. It also explains the dramatic slowdown on growth that occurred in 1993 and suggests a likely course of Medicaid expenditure increases over the remainder of the decade.
Survey Shows “Two Faces” Of Public Opinion On Welfare Reform
Americans Support Time Limits and Tough Work Requirements, But Reluctant to Abandon Those In Need
Public Defines Welfare Broadly Understands Key Details of Welfare Programs
Embargoed for release: 9:00 a.m. EST, Thursday, January 12, 1995
For further information contact: Matt James or Tina Hoff
Menlo Park, CA — A new Kaiser/Harvard survey of Americans nationwide has found that the public supports strong welfare reform measures, such as time limits and work requirements, but is reluctant to simply cut people off and leave them without some means of basic support.
The survey identifies four core beliefs that shape the public’s policy preferences. Two lead the public to support time limits and other strong welfare policies: the belief that welfare causes more harm than good because it discourages work and causes family break up, and the belief that welfare costs the taxpayer too much money. But two other core beliefs make the public concerned that these same strong policies will leave low income people without basic support: the belief that lack of economic opportunity as much as personal responsibility is the reason people need welfare, and the belief that both government and people themselves have a shared responsibility for ensuring that people have a minimum standard of living.
Two-thirds (68%) of Americans favor ending welfare payments after two years for all able-bodied welfare recipients, including women with pre-school children, and requiring them to take a job. But support for cutting off payments drops to 26 percent if the job pays low wages that would make it difficult to support a family, and to only 16 percent if the person is unable to find a job.
Large majorities favor government providing job training (87%) and public service jobs (74%) for people on welfare, and providing child care to low-income mothers who work or are in job training (85%). After education, training, health and child care benefits have been provided, 56 percent believe welfare recipients should be required to do community service work in exchange for continued benefits or have benefits cut off after a specified period of time. Only 10 percent believe the government should end all aid under these circumstances, and 25 percent believe the government should cut recipients off only after guaranteeing they have a job.
The public’s desire to “do something” about welfare is also reflected in support for limits on welfare. Majorities favor requiring mothers to report the name of a child’s father before they can receive welfare (81%), setting limits or denying welfare to non-citizens, including most legal immigrants (64%), denying additional benefits to women who have more children while on welfare (59%), and government limiting how fast welfare programs can grow, regardless of how many people may need assistance (capping welfare) (57%).
Nearly equal proportions of Americans say: 1) “We shouldn’t let people who can’t get or hold a job go hungry or homeless, and we need to continue welfare payments to these people” (44%), and 2) “We should have a firm limit on how long people can stay on welfare, regardless of the consequences, in order to get them to work” (43%).
“The jury is still out on what the public will support on welfare reform. At the moment they want four things that may be incompatible — get people off welfare within two years, get them jobs that provide a minimum standard of living, don’t let families suffer severe hardship, and don’t raise taxes or cut government programs to do these things,” said Drew Altman, Kaiser Family Foundation president and former welfare commissioner in New Jersey under Governor Tom Kean.
Two-thirds of Americans (66%) oppose a proposal that would end welfare benefits for unmarried women and their children if that meant some of the children would have to be cared for in group homes or orphanages. If such a proposal were enacted, the public overwhelmingly prefers having the government pay for group homes where mothers and their children live together (56%), rather than providing orphanages for the children (8%) or doing nothing (8%). A fourth of respondents said none of the above.
One important caveat should be added. The public is not prepared to sacrifice very much to see reforms enacted. Only about half are willing to pay more taxes or see other programs cut to provide job training (53% willing to 40% unwilling) and public service jobs (47% to 45%).
Awareness of Reform Proposals
At this early stage, the public is not yet following the welfare reform debate closely. In sharp contrast to the 47% who said in October 1993 that they were following news stories and other information about health care reform very closely (Kaiser/Harvard Survey, October 1993), only 13% say in this survey they have been following stories about welfare reform very closely.
Only three in ten Americans say they understand President Clinton’s welfare proposals very (5%) or fairly well (25%). A similar proportion understand the Republican proposals very (7%) or fairly well (24%).
“Americans do not yet know the consequences of the various welfare reform proposals,” said Dr. Robert J. Blendon, Professor and Chairman of the Department of Health Policy and Management at Harvard University. “As the debate continues and begins to focus on the implications of particular proposals — whether they be severe negative consequences for individuals and families or increased taxes or cuts in other government programs — the public is likely to become more cautious.”
Welfare Spending
Asked to choose from a list of six areas which two consumed the largest share of federal spending, only 14 percent correctly named Social Security and 37 percent named defense as one of the top two. Four-in-ten Americans (40%) thought welfare was one of the two largest areas of federal spending.
When asked to define welfare, the public identified the following six major federal government programs from a list of nine as being welfare programs: food stamps (93%), AFDC (Aid to Families with Dependent Children) (85%), public housing (85%), WIC (the Women, Infants, and Children program) (72%), the school lunch program (62%) and Medicaid (60%). Most did not regard Supplemental Security Income (SSI), the federal cash assistance program for the aged, blind, and disabled, as welfare. These six major programs labelled by the public as welfare make up 10.2 percent of the 1993 budget, ranking behind defense (21%) and Social Security (21%), and equal to Medicare (10.2%).
State and Federal Roles
The public wants to see the states play a major role in welfare reform. Given four choices, a majority (52%) thought government officials should experiment with reform at the state level, compared to 29 percent who preferred reform at the national level, 7 percent who wanted to leave welfare as it is, and 6 percent who would prefer to eliminate all welfare benefits.
But Americans are wary of letting states determine their own policies without some federal guidelines. While 36 percent thought each state should determine the best way to aid poor people, 50 percent believed the federal government needs to set guidelines when it gives money to states, in order to assure they will treat everyone fairly and do the right thing for poor people.
A majority of Americans (58%) also favor a “swap” proposal, where states would be in charge of welfare and the federal government would take responsibility for paying for the health care of poor people, instead of both responsibilities being shared as they are now. Twenty-four percent are opposed, and 18 percent said they didn’t know.
Core Beliefs and Values
Americans’ beliefs about what policies and reforms should be enacted can be related back to four core values they hold about welfare and poverty:
The overwhelming majority (81%) think that most welfare recipients are able to work. The idea that welfare discourages people from working was identified by half of Americans (49%) as what bothers them most about the current welfare system ranking far ahead of concerns such as costing taxpayers too much (14%) and causing families to break up (13%). Two-thirds (68%) say that welfare encourages women to have more children than they would have if they were not able to get welfare.
Public Knowledge
With some significant exceptions, the public is reasonably well informed about the welfare system. For example:
Methodology
The Kaiser/Harvard Survey was a random-sample, telephone survey of adults nationwide. The national sample consisted of 1,200 adults and was conducted between December 27 and 29, 1994. The survey was designed by the Harvard University School of Public Health’s Department of Health Policy and Management and the Kaiser Family Foundation, and was conducted by KRC Communications Research, a national opinion research firm located in Newton, Massachusetts. The margin of error in the national sample is plus or minus 3 percent. The survey is the first conducted under a new program, the Kaiser/Harvard program on the Public and Health/Social Policy, designed to monitor public knowledge, values and beliefs on health and health-related issues.
The Kaiser Family Foundation, based in Menlo Park, California, is a non-profit, independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries. The Foundation’s work is focused on four main areas: health policy, reproductive health, HIV, and health and development in South Africa. The Foundation does not support any particular proposal or approach to welfare reform.
Note: This publication is not available on our website. However, the data from these surveys is still available through the Public Opinion and Media Research Group. Please email kaiserpolls@kff.org for more information.
The three separate random-sample telephone surveys of adults ages 18 and older living in the United States, Canada, and the Netherlands, designed by the Henry J. Kaiser Family Foundation in association with Louis Harris and Associates, Inc and conducted in 1995. The surveys were conducted to assess differences in public knowledge, opinions, and practices related to pregnancy and birth control, hoping to help explain some of the variation in unplanned pregnancy rates between the U.S. and other developed nations.
This paper presents the results of a survey of 39 states and their DSH payments and the special financing arrangements in those states.