Background: A Strategy for Change

The Urban Initiative for Reproductive Health is a groundbreaking, multi-year initiative to create and promote real policy solutions to address the reproductive health challenges facing cities today. Launched at the National Summit in 2008, the Urban Initiative brings together mayors, city legislative leaders, county executives, public health officials and advocates to advance an agenda promoting policies and programs that increase access to comprehensive reproductive health services, reduce unintended pregnancies, address reproductive health disparities, and lead to healthier birth outcomes.

THE CHALLENGE: In the United States, women living in urban centers are more likely to be in their reproductive years than their rural counterparts. For many reproductive health indicators, city residents experience worse reproductive health outcomes compared to the national average. Many poor reproductive health indicators are linked with some of the systemic problems affecting urban areas: poverty, racism, shortage of affordable housing, crime, lack of adequate public transportation, and the concentration of environmental pollutants and toxins.

THE OPPORTUNITY: Despite the formidable challenges facing many urban communities, there are untapped opportunities to create and implement a proactive agenda around reproductive health and rights if we work collectively:

  • Many committed, progressive, pro-choice, pro-family planning elected and public health officials have the political will and influence to drastically improve the health of families living in their municipalities.
  • Collaboration between local advocates and public officials provides an opportunity to create new and innovative models of municipal legislation and resolutions that can strengthen the rights of women to access the full range of reproductive health services.
  • Working locally allows for targeted interventions at the community level to provide resources and support where they are needed most.
  • Addressing urban reproductive health issues at the local level also has significant benefits for grassroots and advocacy organizations. Local officials are often more accessible and more accountable to organizations dedicated to expanding access to services and information in the communities they represent. Moreover, because the reproductive health challenges facing individuals in urban settings are so intricately linked to other social inequities, there is a great opportunity to work across different movements and issue areas to create a stronger, more unified, progressive and diverse coalition dedicated to ensuring reproductive justice for urban communities.


  • Identifying elected leaders and public health officials who embrace a proactive policy agenda to reduce unintended pregnancy and improve the reproductive health of their communities;
  • Providing a forum for elected leaders and public health officials to share their knowledge, expertise, and experiences;
  • Supporting a new generation of leaders who can effectively communicate a progressive agenda for reproductive health in their communities;
  • Establishing a clearinghouse of promising local models of policies and programs that are funded, administered, or legislated at the municipal level; and
  • Fostering collaboration between advocates, elected leaders, and public officials in cities across the nation to create and implement the National Urban Reproductive Health Agenda.
© 2012 National Institute for Reproductive Health