The landmark Supreme Court decision, Roe vs. Wade in 1973, established the constitutional right to abortion while simultaneously providing states with regulatory power over access to reproductive health services (Gaj et al 2021). Around the world through the end of the 20^th century, other high-income countries and western democracies followed suit to expand abortion care, reproductive rights, and access to reproductive health services for women (Volgelstein and Turkington 2019).

Yet in 2018, many states across the U.S. began passing legislation and issuing lawsuits challenging women’s access to reproductive health services (Guttmacher 2022; Gaj 2021). Since 2021, 8 states enacted bans on abortion (Guttmacher 2021). The 2021 laws were in direct conflict with Roe, in an attempt to appeal to the Supreme Court to take up the case as a challenge to Roe with a new conservative majority on the Court. The Supreme Court of the United States reversed the landmark constitutional protection for the right to abortion on June 24^th, 2022.

The reversal of Roe vs. Wade by the Supreme Court has direct implications for individual and population health, and health equity in the United States. Protection of reproductive rights is a key indicator of health outcomes and health equity for women and children around the world (Winney 2021). Countries with protections for reproductive rights and access to services have better health outcomes for women, infants and children, and reduced inequality (Bearak et al 2020; OECD 2019). Restricted access to reproductive health services disproportionately affects people living in poverty and people of color, most acutely affecting Black and Indigenous persons (Perritt 2021). Furthermore, constraints on abortion access increase rates of second trimester abortions, which have significantly higher rates of morbidity and mortality for women and infants (White 2021). Such restricted access will likely exacerbate health disparities across populations and harm to low-income and communities of color. Disparities across geographies will also emerge, where some states will likely completely or partially ban access to abortion and other reproductive health services, while other states seek to enhance protections (Chiwaya and Da Silva 2022).

The United States is the first high-income, western democracy in the modern era to roll back protections for reproductive rights and health services (Davis and Londras 2021). Access to abortion care as an essential part of reproductive medical services, and protections for reproductive rights are core tenets of Civil Liberties, Human Rights, and Equity in democratic nations by the World Health Organization, the United Nations, and the OECD (OECD 2019; United Nations 2018; WHO 2021).

The Cornell Master of Public Health Program stands with the American Public Health Association and the Association of Schools and Programs of Public Health in holding that access to all essential reproductive health services, including abortion, is a fundamental right. As public health practitioners, we have a duty to protect the health of all populations, of which access to abortion care, reproductive medical services, contraceptives, and reproductive rights should be protected for all persons.

Statement from the Cornell Master of Public Health Program Authored by Charley Willison