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Menstrual Equity: A Survey Study with ZIP-Code Level Analysis

ORIGINAL RESEARCH

Rosalie Mattiola, Susan E. Hansen, Shae Duka, Amanda Hoyer, Belle P. Marks, Crystal Perez, Nicole Burgess, Ashwini Kamath Mulki

Corresponding Author: Ashwini Kamath Mulki, MD, MBBS, MPH; Valley Health Partners Family Health Center

Email: ashwini.kamathmulki@lvhn.org

DOI: 10.3122/jabfm.2025.250089R1

Keywords: Community-Based Research, Health Disparities, Health Equity, Menstrual Hygiene Products, Pennsylvania, Poverty, Public Health, Reproductive Health, Social Justice, Women's Health

Dates: Submitted: 03-04-2025; Revised: 05-05-2025; Accepted: 05-19-2025

Status: In production. 

OBJECTIVES: This cross-sectional retrospective survey study modeled on previous research explored the prevalence of period poverty in one urban setting to inform future targeted interventions toward improving menstrual equity.

METHODS: An eight-item questionnaire was developed by a menstrual health equity work group led by the Allentown, Pennsylvania health bureau. Data collection occurred for 1.5 years, using an anonymous online survey tool and convenience sampling. Study participants were recruited with an informational flier (with QR code and web address pointing to the questionnaire) posted in various public locations.

RESULTS: A total of 353 people who menstruate, aged 13-54, representing five of Allentown’s seven ZIP code regions responded. The majority were impacted by period poverty, either by missing a life event (77.9%) or engaging in an at-risk menstrual hygiene behavior (79.0%). Most (91.5%) had been educated in menstrual health. Doctor’s offices (40.3%) and social media (27.8%) were the most frequently cited sources for learning about the survey. ZIP codes were significantly associated with engaging in at-risk behaviors (P < .001), missing a life event (P < .001), no menstrual health education (P = .03), and preference for period underwear (P = .04). Age was significantly associated with preferring pads (P = .007) and tampons (P = .03).

CONCLUSIONS: Period poverty was found to impacts a substantial number of people Allentown, Pennsylvania, residents. Interventions will need to be tailored to ZIP code and age group. Future study should aim for a larger sample size and additional questions, about menstrual education. 

ABSTRACTS IN PRESS

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