• Danielle R Gartner, Kemi M Doll, Robert A Hummer, and Whitney R Robinson.
• From the Carolina Population Center, and the Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
• South. Med. J. 2018 Oct 1; 111 (10): 585590585-590.

ObjectiveFor decades hysterectomy rates have famously demonstrated unexplained geographic variation. The aim of this study was to identify county-level correlates of hysterectomy rates among reproductive-age women.MethodsUsing county-level data from multiple sources, linked with claims-based surveillance data of every hysterectomy performed among women ages 20 to 44 in North Carolina from 2011 to 2013 (N = 7180), we explored social, economic, and healthcare factors associated with county-level rates.ResultsAfter accounting for spatial autocorrelation, county-level hysterectomy rates were negatively associated with county-level median household income, positively associated with the proportion married, and not associated with measures of healthcare capacity or access.ConclusionsThis analysis provides preliminary evidence that contemporary hysterectomy use in North Carolina occurs along socioeconomic lines.

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