Context: This paper focuses on whether and the extent to which the resources made available by Title X, the only federal policy aimed specifically at reproductive health care, are equitably accessible. Here, equitable means that barriers to access services are lowest for those people who need them most.

Methods: We use geographic information systems (GIS) and statistical/spatial analysis—specifically the integrated two-step floating catchment area (I2SFCA) method—to study the spatial and non-spatial accessibility of Title X Clinics in 2018.

Findings: We find that contraception deserts vary across the states, with between 17–53% of the state population living in a desert. Further, we find that low-income people and people of color are more likely to live in certain types of contraception deserts.

Conclusions: Our analyses not only reveal a wide range of sizes and shapes of contraception deserts across the US states, but also a range of severity of inequity.

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Supplementary data