Breast and cervical cancer screening

Impact of health insurance status, ethnicity, and nativity of Latinas

Michael A. Rodríguez, Lisa M. Ward, Eliseo J. Pérez-Stable

Research output: Contribution to journalArticle

127 Citations (Scopus)

Abstract

PURPOSE: Although rates of cancer screening for Latinas are lower than for non-Latina whites, little is known about how insurance status, ethnicity, and nativity interact to influence these disparities. Using a large statewide database, our study examined the relationship between breast and cervical cancer screening rates and socioeconomic and health insurance status among foreign-born Latinas, US-born Latinas, and non-Latina whites in California. METHODS: Data from the 1998 California Women's Health Survey (CWHS) were analyzed (n = 3,340) using multiple logistic regression models. Utilization rates of mammography, clinical breast examinations, and Papanicolaou (Pap) smear screening among foreign-born Latinas, US-born Latinas, and non-Latina whites were the outcome measures. RESULTS: Foreign-born Latinas had the highest rates of never receiving mammography, clinical breast examinations, and Pap smears (21%, 24%, 9%, respectively) compared with US-born Latinas (12%, 11%, 7%, respectively) and non-Latina whites (9%, 5%, 2%, respectively). After controlling for socioeconomic factors, foreign-born Latinas were more likely to report mammography use in the previous 2 years and Pap smear in the previous 3 years than non-Latina whites. Lack of health insurance coverage was the strongest independent predictor of low utilization rates for mammography (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.53-2.76), clinical breast examinations (OR = 2.29; 95% CI, 1.80-2.90) and Pap smears (OR = 2.89; 95% CI, 2.17-3.85.) CONCLUSIONS: Breast and cervical cancer screening rates vary by ethnicity and nativity, with foreign-born Latinas experiencing the highest rates of never being screened. After accounting for socioeconomic factors, differences by ethnicity and nativity are reversed or eliminated. Lack of health insurance coverage remains the strongest predictor of cancer screening underutilization.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalAnnals of Family Medicine
Volume3
Issue number3
DOIs
StatePublished - May 2005

Fingerprint

Insurance Coverage
Health Insurance
Early Detection of Cancer
Hispanic Americans
Uterine Cervical Neoplasms
Health Status
Breast Neoplasms
Papanicolaou Test
Mammography
Breast
Odds Ratio
Confidence Intervals
Logistic Models
Women's Health
Health Surveys
Outcome Assessment (Health Care)
Databases

Keywords

  • Breast neoplasms
  • Cervix neoplasms
  • Delivery of health care
  • Minority groups
  • Prevention & control, Hispanic Americans

ASJC Scopus subject areas

  • Family Practice

Cite this

Breast and cervical cancer screening : Impact of health insurance status, ethnicity, and nativity of Latinas. / Rodríguez, Michael A.; Ward, Lisa M.; Pérez-Stable, Eliseo J.

In: Annals of Family Medicine, Vol. 3, No. 3, 05.2005, p. 235-241.

Research output: Contribution to journalArticle

Rodríguez, Michael A. ; Ward, Lisa M. ; Pérez-Stable, Eliseo J. / Breast and cervical cancer screening : Impact of health insurance status, ethnicity, and nativity of Latinas. In: Annals of Family Medicine. 2005 ; Vol. 3, No. 3. pp. 235-241.
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abstract = "PURPOSE: Although rates of cancer screening for Latinas are lower than for non-Latina whites, little is known about how insurance status, ethnicity, and nativity interact to influence these disparities. Using a large statewide database, our study examined the relationship between breast and cervical cancer screening rates and socioeconomic and health insurance status among foreign-born Latinas, US-born Latinas, and non-Latina whites in California. METHODS: Data from the 1998 California Women's Health Survey (CWHS) were analyzed (n = 3,340) using multiple logistic regression models. Utilization rates of mammography, clinical breast examinations, and Papanicolaou (Pap) smear screening among foreign-born Latinas, US-born Latinas, and non-Latina whites were the outcome measures. RESULTS: Foreign-born Latinas had the highest rates of never receiving mammography, clinical breast examinations, and Pap smears (21{\%}, 24{\%}, 9{\%}, respectively) compared with US-born Latinas (12{\%}, 11{\%}, 7{\%}, respectively) and non-Latina whites (9{\%}, 5{\%}, 2{\%}, respectively). After controlling for socioeconomic factors, foreign-born Latinas were more likely to report mammography use in the previous 2 years and Pap smear in the previous 3 years than non-Latina whites. Lack of health insurance coverage was the strongest independent predictor of low utilization rates for mammography (odds ratio [OR] = 2.05; 95{\%} confidence interval [CI], 1.53-2.76), clinical breast examinations (OR = 2.29; 95{\%} CI, 1.80-2.90) and Pap smears (OR = 2.89; 95{\%} CI, 2.17-3.85.) CONCLUSIONS: Breast and cervical cancer screening rates vary by ethnicity and nativity, with foreign-born Latinas experiencing the highest rates of never being screened. After accounting for socioeconomic factors, differences by ethnicity and nativity are reversed or eliminated. Lack of health insurance coverage remains the strongest predictor of cancer screening underutilization.",
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T2 - Impact of health insurance status, ethnicity, and nativity of Latinas

AU - Rodríguez, Michael A.

AU - Ward, Lisa M.

AU - Pérez-Stable, Eliseo J.

PY - 2005/5

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N2 - PURPOSE: Although rates of cancer screening for Latinas are lower than for non-Latina whites, little is known about how insurance status, ethnicity, and nativity interact to influence these disparities. Using a large statewide database, our study examined the relationship between breast and cervical cancer screening rates and socioeconomic and health insurance status among foreign-born Latinas, US-born Latinas, and non-Latina whites in California. METHODS: Data from the 1998 California Women's Health Survey (CWHS) were analyzed (n = 3,340) using multiple logistic regression models. Utilization rates of mammography, clinical breast examinations, and Papanicolaou (Pap) smear screening among foreign-born Latinas, US-born Latinas, and non-Latina whites were the outcome measures. RESULTS: Foreign-born Latinas had the highest rates of never receiving mammography, clinical breast examinations, and Pap smears (21%, 24%, 9%, respectively) compared with US-born Latinas (12%, 11%, 7%, respectively) and non-Latina whites (9%, 5%, 2%, respectively). After controlling for socioeconomic factors, foreign-born Latinas were more likely to report mammography use in the previous 2 years and Pap smear in the previous 3 years than non-Latina whites. Lack of health insurance coverage was the strongest independent predictor of low utilization rates for mammography (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.53-2.76), clinical breast examinations (OR = 2.29; 95% CI, 1.80-2.90) and Pap smears (OR = 2.89; 95% CI, 2.17-3.85.) CONCLUSIONS: Breast and cervical cancer screening rates vary by ethnicity and nativity, with foreign-born Latinas experiencing the highest rates of never being screened. After accounting for socioeconomic factors, differences by ethnicity and nativity are reversed or eliminated. Lack of health insurance coverage remains the strongest predictor of cancer screening underutilization.

AB - PURPOSE: Although rates of cancer screening for Latinas are lower than for non-Latina whites, little is known about how insurance status, ethnicity, and nativity interact to influence these disparities. Using a large statewide database, our study examined the relationship between breast and cervical cancer screening rates and socioeconomic and health insurance status among foreign-born Latinas, US-born Latinas, and non-Latina whites in California. METHODS: Data from the 1998 California Women's Health Survey (CWHS) were analyzed (n = 3,340) using multiple logistic regression models. Utilization rates of mammography, clinical breast examinations, and Papanicolaou (Pap) smear screening among foreign-born Latinas, US-born Latinas, and non-Latina whites were the outcome measures. RESULTS: Foreign-born Latinas had the highest rates of never receiving mammography, clinical breast examinations, and Pap smears (21%, 24%, 9%, respectively) compared with US-born Latinas (12%, 11%, 7%, respectively) and non-Latina whites (9%, 5%, 2%, respectively). After controlling for socioeconomic factors, foreign-born Latinas were more likely to report mammography use in the previous 2 years and Pap smear in the previous 3 years than non-Latina whites. Lack of health insurance coverage was the strongest independent predictor of low utilization rates for mammography (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.53-2.76), clinical breast examinations (OR = 2.29; 95% CI, 1.80-2.90) and Pap smears (OR = 2.89; 95% CI, 2.17-3.85.) CONCLUSIONS: Breast and cervical cancer screening rates vary by ethnicity and nativity, with foreign-born Latinas experiencing the highest rates of never being screened. After accounting for socioeconomic factors, differences by ethnicity and nativity are reversed or eliminated. Lack of health insurance coverage remains the strongest predictor of cancer screening underutilization.

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KW - Cervix neoplasms

KW - Delivery of health care

KW - Minority groups

KW - Prevention & control, Hispanic Americans

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