Area-level mortality and morbidity predict 'abortion proportion' in England and Wales

Life history theory predicts that where mortality/morbidity is high, earlier reproduction will be favoured. A key component of reproductive decision-making in high income contexts is induced abortion. Accordingly, relationships between mortality/morbidity and 'abortion proportion' (proportion of conceptions ending in abortion) are explored at small-area ('ward') level in England and Wales. It is predicted that where mortality/morbidity is high, there will be a lower 'abortion proportion' in younger women (< 25 years), adjusting for education, unemployment, income, housing tenure and population density. Results show that this prediction is supported: wards with both shorter life expectancy and a higher proportion of people with a limiting long-standing illness have lower abortion proportions in under 25 s. In older age bands, in contrast, elevated mortality and morbidity are mostly associated with a higher 'abortion proportion'. Further, morbidity appears to have a larger effect than mortality on 'abortion proportion' in the under-25 age band, perhaps because a) morbidity is be more salient than mortality in high-income contexts, and/or b) young women are influenced by health of potential female alloparents when scheduling fertility.