Expanding the Evidence Base on Reproductive Health

In the last 10 years, there are only 3 countries in the world that have gone backwards on abortion: El Salvador, Poland, and the United States.

Every other country has been static, or has taken steps to decriminalize or legalize abortion because of the realization of the detrimental public health implications of restrictive access. These decisions have been influenced by concerns around maternal mortality, protecting both health and human rights, and the classification of abortion as a medical intervention.

The reversal of Roe v. Wade rocked the U.S. in 2022, a year later, it threatens to undermine  reproductive health care not only in the US but across the world. Sofia Gruskin, JD, MIA, is a Professor of Population and Public Health Sciences, and the Director of the USC Institute on Inequalities in Global Health. Much of her work seeks to expand the evidence base through examining and documenting the impacts that law has on health outcomes. The Dobbs v. Jackson Women’s Health Organization Supreme Court ruling, is a pertinent example where changes at the Supreme Court level result in changes in health policies with extensive consequences for people everywhere.

Gruskin’s work is leading efforts to mobilize action on reproductive health and rights across territories. Her team of faculty have published widely on the realities of sexual and reproductive health, including abortion, in this unpredictable era.  They convene a space within the Department of Population and Public Health Sciences, that hosts discussions to assess the implications on the reversal on the right to abortion, exploring its effects in California, the U.S. and around the world. Speakers include scholars and activists such as MacArthur Genius Loretta J. Ross respectively.

“Global health isn’t just about what is happening ‘out there,’ but also what is occurring in LA,” maintains Gruskin. In Los Angeles County, she has been working with the Office of Women’s Health to address critical health issues raised by the Dobbs decision. This collaboration involves undergraduate students from the Global Health concentration, who have compiled fact sheets, responding to misconceptions about abortion, and creating a resource, listing services available to survivors of violence.

Nationally, Gruskin is also part of a coalition of stakeholders to investigate what role Los Angeles can take on—especially since November when California passed a constitutional amendment that provides a constitutional right to reproductive freedom, including the right to an abortion. Partnerships like these give rise to important research questions, as well as protections and provisions for our students who live in states where abortion is no longer legal. “It’s not just abortion restrictions, but how these changes in law further open restrictions on anything to do with sexuality, contraception including tracking of menstruation. These morph into government issues as opposed to something that’s private,” affirms Gruskin. 

Internationally, the ramifications of the reversal, threaten to set back global trends. “There are strong connections between local and global,” reminds Gruskin who has published a joint report about the impact of overturning Roe v. Wade in other parts of the world. The report discloses that every year, 7 million women suffer from complications of unsafe abortions with an estimate of up to 31,000 deaths annually. A major concern about changes in U.S. policy is how these numbers will go up here in the US,  as well as the changes that may result in allocation of resources to address the fallout of unsafe abortion. Gruskin and her team are currently partnering with the WHO to assess the changing legal environment impacting sexual and reproductive health and to assess the sorts of policy dialogues needed to address these challenges moving forward.

At USC, Gruskin is a member of a coalition formed by Dean Carolyn L. Meltzer, Keck School of Medicine of USC as well as the lead investigator for the USC Law and Global Health Collaboration, which will focus on the role of USC in ensuring equity in access to abortion and other sexual and reproductive health rights in LA moving forward, to be held in April 2023.

The USC Institute on Inequalities in Global Health recently released its 2021-2022 Annual Report. Read the report here.