The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade (1973) and Planned Parenthood v. Casey (1992), invoked a historic shift in women’s health that Boston University health law professor Julia Raifman calls “structural.” violence.”
Structural violence is a form of violence in which people are unable to meet their basic needs due to social structures or institutions. When abortion is considered a human right, as Raifman believes, the decision to restrict access to it — which is happening in at least 19 states as a result of the ruling — becomes a structurally violent decision.
“It’s a political decision that hurts the entire population and exacerbates disparities,” Raifman told Boston.com this week.
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The United States already has higher rates of maternal mortality and child poverty than many other countries, and she said overthrowing Roe would only make these existing problems worse.
Raifman, who is an assistant professor in the Department of Health Law, Policy, and Management at the Boston University School of Public Health, studies how health and social policies affect population health and health disparities.
“[The overturn] threatens the bodily autonomy of anyone who can give birth and the sense of security of anyone who cares about someone who can give birth, so I think that’s really important,” Raifman said.
And this policy will have long-term negative effects, she said. Raifman referred to the Turnaway study, led by University of California San Francisco professor Diana Greene Foster, which followed 1,000 women seeking abortions for 10 years. The women were divided into two groups, with one group receiving desired abortions and the other group being denied at abortion clinics.
The study found that six months later, women who had been denied an abortion were three times more likely to be unemployed than women who had an abortion. A year later they were less likely to have ambitious future plans, and five years later they were four times more likely to be living in poverty. Raifman noted that the pandemic has only further exacerbated the problem of poverty.
“Low-income people face repeated COVID infection, their children face repeated COVID infection in schools; a single parent may have to miss several weeks of work due to COVID, and they may not be able to miss several weeks of work, they may be laid off,” Raifman said.
Raifman’s previous work has focused on how equal rights for LGBTQ+ people improve health and well-being, and how religious denial policies that allow denial of services to LGBTQ+ people undermine their health. She equated this research with Roe’s reversal — a policy that takes away the rights of a subset of people in the population — and said that even beyond the loss of abortion rights, the reversal makes her nervous for the larger effects of not having this choice available.
“It’s time to recognize that we are in crisis – when so much of the population is losing their basic rights – and that the crisis applies to everyone in our society and in our democracy,” Raifman said. . “A lot of people who seek abortions have other children and are looking after not just themselves but their whole family.”
One of Raifman’s main concerns is that the reversal means women are no longer seen as equals in the eyes of the law.
“I think that’s one of the most important parts of it, in addition to all the direct language it brings to people who live in states that have banned abortion,” Raifman said.
Raifman warned of what could happen next. She believes that maintaining a democracy that we all enjoy and in which we are all valued requires substantive action.
“This [policy] makes people who can give birth unequal; there are a lot of policies that make LGBT people unequal,” Raifman said. “I think we will only see more of these erosions of human rights and the foundations of our democracy unless there is decisive action to improve the legitimacy of our institutions and their ability to uphold the human rights.”
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