Taylor Riley shares why community voices are necessary for advancing sexual and reproductive health equity

(left to right) Katherine Chen, Anya Fogel, Taylor Riley, Kels Cook, and Kimberly Chen were among the UW students who advocated for emergency contraception vending machines across public college campuses in Washington state. (Photo courtesy Taylor Riley) 

As Taylor Riley spoke with advocates and policymakers in Washington state about the importance of access to abortion on college campuses, the policymakers had some questions: How many people need it? What are the barriers to care? Which schools have clinics that can implement medication abortion and which don’t? They told Riley and other UW student advocates that they were interested in supporting this work, but they’d need data to back up policies.

So Riley, a doctoral student at the time in epidemiology at the University of Washington School of Public Health (SPH), set about answering these questions through research. This was in the year following the U.S. Supreme Court’s rollback of Roe v. Wade and rising concerns about abortion access. Riley collected and analyzed data on availability and barriers to medication abortion among Washington state public college students. This research, which she and fellow students shared with policymakers, is a critical piece in their advocacy for expanding sexual and reproductive health care on college campuses.

While Washington still does not have a law that requires public universities to provide students with access to medication abortion — unlike California, Massachusetts and New York — UW student advocacy was able to secure funding for emergency contraception vending machines at Washington public colleges. These colleges can apply for a $10,000 grant to install and supply their vending machines, which include Plan B, pregnancy tests, Tylenol and ibuprofen. There are now 21 technical, community, and four-year colleges across the state with funding to install and stock emergency contraception vending machines.

“My goal in any public health research is to advance health justice and equity, which means not keeping research siloed behind paywalls but to actually have it be informed, conducted and used by advocates, policymakers and community organizers,” Riley said.

This pairing of advocacy, rigorous research and policy has been Riley’s north star throughout graduate school. For her academic excellence and commitment to public health, Riley received the 2024 Gilbert S. Omenn Award for Academic Excellence, one of the most prestigious School-wide recognitions for master’s and doctoral students.

Having earned her doctorate in epidemiology and a certificate in demography, it’s been just as important for Riley to learn from her classes as it has been to learn from communities in Seattle and nationally about how to advance health equity. Faculty have commended the way Riley incorporates and learns from communities in her research.

“In the past, few social epidemiologists conducted community-engaged research or incorporated mixed-methods approaches. Taylor insists upon doing so,” said Anjum Hajat, associate professor of epidemiology. “For Taylor, community-engaged research ensures that social justice values are embodied in all aspects of her research. The desire to co-create knowledge with those who experience the harms of structural racism is central to her research.” 

UW's on-campus emergency contraception vending machine which provides Plan B, pregnancy tests, Tylenol and ibuprofen. (Photo by Elizar Mercado). 


The importance of community-based research

As part of Riley’s advocacy work around reproductive health and rights in Seattle, she became connected with Open Arms Perinatal Services, a Seattle-based organization that provides free community-based support during pregnancy, birth, and early parenting for low-income families in Washington state.

“As many folks have said before me and many more will continue to say, the solutions for complex public health issues lie in the communities most directly impacted,” Riley said. “We have public health skills and training in academia and we also have access to institutional resources. It’s important we leverage this privilege and access to support community organizations who are already doing vital public health work.”

Riley previously worked as a doula herself and, alongside Open Arms, figured out how to use her public health and doula training to support the work of community-based doulas. This co-created research aimed to document the factors contributing to successful implementation and sustainability of community-based doula programs. Riley and the Open Arms research team secured funding from the UW Population Health Initiative to support this work.

More attention has been recently paid to doulas, and especially community-based doulas who are from the same communities they serve, as a way to address U.S. maternal mortality. Maternal mortality disproportionately impacts people of color, with Black women being three times more likely to die from pregnancy-related complications than white women.

While Open Arms’ doulas address a wide swath of health needs that helps to improve health outcomes, including support around housing, food, and lactation, this research highlighted that the burden of ameliorating the racialized disparities in maternal health should not be placed solely on doulas, and more resources are needed to support their important work. As Dila Perera, UW SPH alum and executive director at Open Arms, says, “Doulas are not a vaccine.” Riley says the holistic services of community-based doula programs are essential to meet the needs of marginalized birthing families, but there is a simultaneous need for more funding and structural supports for the programs and individuals providing this care.

Riley’s work with Open Arms was one of several parts of her dissertation, which broadly interrogated the reproductive health impacts of structural gendered racism. The work of measuring intersecting systems of oppression, like structural racism and sexism, is an important and nascent area of study in social epidemiology. While there has been much discussion and awareness of the connection between structural racism and health inequities, epidemiologists have only recently started to study how to measure it. The first part of Riley’s dissertation, published in Social Science and Medicine, looked at how the intersecting forces of structural racism and sexism are mutually reinforcing and produce poor health and preterm birth among Black and racially minoritized women.

The second part of her dissertation, published in the Journal of Epidemiology and Community Health, looks locally at neighborhood policing as a determinant of preterm birth in Seattle. Riley found that Black birthing people living in neighborhoods with higher frequencies of police stops had higher risks of preterm births compared to their counterparts living in neighborhoods with fewer police stops. Riley says this study contributes to the growing evidence of policing and criminalization as a contextual stressor and structural barrier to health equity. She described how these findings support the long-term calls of community members and activists, like Seattle Solidarity Budget, to limit the presence of policing and instead invest in programs that address the root causes of harm and poor health, like affordable housing and health care.

While this research may seem separate from her work on abortion, Riley emphasizes these issues are interrelated: “The criminalization and surveillance of communities of color, as seen in this study as associated with increased preterm birth among Black residents, are the same societal forces that criminalize abortion and restrict people’s bodily autonomy,” Riley said.


Advancing reproductive health together

Riley’s journey into sexual and reproductive health research and advocacy began when she was living in southwest Virginia. When she sought out contraception and abortion options, she couldn’t find them, and instead faced a culture of shame and stigma around these resources. She felt the unfairness of this and wanted to do something to change it.

These experiences stuck with her, and so after graduating from Davidson College with a degree in political science and working in North Carolina’s free clinics, she began Columbia University’s master’s of public health program, where she studied population and family health. She then joined the Guttmacher Institute, a research and policy non-governmental organization, where she researched contraception, abortion and maternal health globally.

Taylor Riley at Excellence Awards
Taylor Riley received the 2024 Gilbert S. Omenn Award for Academic Excellence, one of the most prestigious School-wide recognitions for master’s and doctoral students. (Photo by Elizar Mercado).

She eventually came to the UW to pursue her epidemiology doctorate because she wanted strong methodological skills to answer research questions around topics like how structural and social factors influence reproductive health outcomes.

In 2022, after the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization ruling, many states restricted access to abortion. Concerns around access to reproductive health rose across the country, and Riley became a leader, both at the UW and in Washington state, on sharing timely information for what this ruling meant for public health. She wrote and co-authored op-eds in The Seattle Times and The Stranger advocating for reproductive health protections and served as a subject expert for local news outlets, including The Seattle Times and KUOW.

Riley recently led a study published in JAMA Network Open on changes in abortion provision and delays to abortion care in Washington after the Dobbs decision. “We used a rigorous interrupted time series design and found substantial increases in the total number of abortions, among both Washington residents and more people traveling from out of state after the Dobbs decision,” Riley said. They also found increased delays where people were receiving care a week later in gestation, which has important health and economic implications because later abortion care is more expensive, has a higher risk of complications, and delayed care impacts people’s mental health.

Her professors noted how prolific her academic work has been on this topic: Riley has 29 peer reviewed publications, 16 of them first authored. Riley hopes this work will add to the effort of reducing the stigma surrounding abortion, both in research and in society. 

“Even within public health, abortion can be stigmatized,” Riley said. “Abortion is very common and there’s a misperception that it’s not. One in four women will have an abortion in their lifetime and we all know and love someone who has had an abortion.”

This autumn, Riley will be joining the University of North Carolina’s Carolina Population Center as a postdoctoral fellow, where she will conduct research at the nexus of structural racism, criminalization and reproductive health.

As reproductive rights have been rolled back in the U.S., many have questioned what they can do to create change. Riley has prioritized action alongside community to advance reproductive health rights and justice. 

“There is a role people can play to support larger movements and to push back on these scary trends we are seeing of attacks on bodily autonomy,” Riley said. “We are made to feel like we can do nothing, but there are actions we can do as individuals that become strengthened and more powerful when we do it together. Raise money for your local abortion fund, support your local mutual aid groups. We build community and we build power around taking action together.”