Sep 13, 2022
The Women's Reproductive Health Survey (WRHS) of active-duty service members represents the first U.S. Department of Defense–wide survey of only active-duty service women (ADSW) since 1998. The survey focused on several domains: health care utilization; use of birth control and receipt of contraceptive counseling; reproductive health during training, predeployment, and deployment; fertility and pregnancy; and infertility.
The WRHS was a web-based confidential survey, fielded between August 2020 and November 2020. The representative sample consisted of randomly selected ADSW in the U.S. Air Force, Army, Marine Corps, and Navy, excluding trainees and those above flag rank, and a census of Coast Guard ADSW below flag rank.1
The final analytic sample consisted of 23,950 ADSW who responded to the survey and completed at least 50% of questions on contraceptive access. The overall weighted response rate was 17.8%; the response rate in the Marine Corps was 14.9%.
A single imputation process with a sequential imputation model and predictive mean matching was used to account for missing data. Less than 4% of data were missing, mostly owing to survey drop-off.
All analyses use analytic weights, which are the product of design weights (that account for the sampling approach) and nonresponse weights (that account for differential propensity for response based on respondent characteristics). Use of the weights results in a representative sample on many important demographic and military characteristics (e.g., age, race/ethnicity, marital status, education level, number of dependents, service branch, pay grade, years of service, occupation code, recent deployment, and Armed Forces Qualification Test score).
1 Note that the Space Force is not included in the survey as a separate branch and is treated as part of the Air Force in the analysis. At the time of the survey, the female Space Force population was too small to sample on its own.
There are several limitations to this research. First, WRHS response rates are low, although higher than in many recent U.S. Department of Defense–wide surveys. Second, for some subgroups, sample sizes are small; in these instances, estimates are suppressed for confidentiality. Third, the survey language did not specify whether care provided within the Military Health System (MHS) refers only to direct care at military treatment facilities or also includes care elsewhere through TRICARE. Fourth, the survey was fielded during the COVID-19 pandemic, although the impact of the pandemic on the study, if any, is not known.
This infographic depicts work done in the RAND National Security Research Division and documented in The Women's Reproductive Health Survey (WRHS) of Active-Duty Service Members, by Sarah O. Meadows, Rebecca L. Collins, Megan S. Schuler, Robin L. Beckman, and Matthew Cefalu, RR-A1031-1, 2022 (available at www.rand.org/t/RRA1031-1). To view this infographic online, visit www.rand.org/t/IGA1031-4. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. RAND® is a registered trademark.
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To view this infographic online, visit www.rand.org/t/IGA1031-4.