A third of teens and young adults in the United States can’t afford or otherwise access menstrual products. That’s according to new research from Children’s National Hospital in Washington, D.C.

The study found that “period poverty,” insufficient access to menstrual hygiene products and related education, appears to affect young people equally. That’s despite differences in race, ethnicity, neighborhood, or whether they have health insurance.

For the study, the researchers surveyed over 1,800 young people ages 13 to 21, who came into the emergency room at Children’s National from mid-January of this year through the end of June.

Teens and young adults were said to be experiencing period poverty if they said they’d either had to use rags or tissues during their period over the past year, or didn’t have the money to buy tampons or pads.