Authors: Adam Gaffney, MD, MPH, et al.

Abstract: What are the probable health consequences of three US Supreme Court decisions in 2022 that invalidated COVID-19 workplace protections, voided state laws on handgun-carry restrictions, and revoked the constitutional right to abortion?

In this analytical modeling study, the model projected that:

• The Supreme Court ruling to invalidate COVID-19 workplace protections was associated with 1,402 deaths in early 2022.
• The court’s decision to end handgun-carry restrictions will result in 152 additional firearm-related deaths annually.
• The court’s decision to revoke the constitutional right to abortion will result in six to 15 deaths annually, and hundreds of additional cases of peripartum morbidity each year (an extra 782 in 13 states that had abortion bans at March 30, 2023, and 1,967 cases should other ‘high risk’ states apply abortion bans).

“These findings suggest that over a decade, the three Supreme Court decisions examined here will contribute to the loss of nearly 3,000 US lives and possibly many more,” say the analysts.

They also estimate that abortion bans will be associated with 30,440 fewer abortions annually in the 13 states that had abortion bans at March 30, 2023, (related to the driving distance to the nearest abortion facility). If other, ‘high-risk’ states also enact abortion bans, they project 76,612 fewer abortions annually.

“We elected not to model the impact of the likely increase in self-managed abortion or worsened management of ectopic pregnancy, previable preeclampsia, or miscarriage, given greater uncertainty for these outcomes,” say the analysts. “Abortion denial is also expected to force some individuals (and their family members) into poverty, an important social determinant of ill-health that we also did not model.”

Importance: Several US Supreme Court rulings have drawn criticism from the medical community, but till now their health consequences have not been quantitatively evaluated. The authors conclude: “The findings of this study suggest that these Supreme Court decisions may harm the health of US citizens for years, and possibly decades, to come.”

Availability: Published by JAMA.