FACTORS ASSOCIATED WITH SCREENING MAMMOGRAPHY IN LOW-INCOME WOMEN

Despite its effectiveness as a preventive measure, studies indicate th at low-income and minority women are less likely to obtain screening m ammograms than other groups. Using a logistic regression model to adju st for multiple variables, we examined factors associated with women a ge greater than or equal to 40 years of age who obtained a screening m ammogram in a community health center setting from 1990 to 1991 (scree ned, n = 3,521; nonscreened, n = 7,461). Women 50-64 were more likely to be screened than women 40-49 (adjusted relative risk [RR] = 1.57; 9 5% confidence interval [CT] = 1.42, 1.73). Native American, Asian, and women of other races were less likely to be screened than Caucasian, African-American, or Hispanic women (adjusted RR = 0.66; CI = 0.51, 0. 87). Women on Medicaid were twice as likely to be screened than women who received no subsidized care (adjusted RR = 1.99; CI = 1.68, 2.35). Women who received the majority of their care at a community-based he alth clinic were twice as likely to be screened than women who receive d care primarily at a hospital-based ambulatory care site (adjusted RR = 2.34; CI = 2.06, 2.65). The greatest difference in adjusted RR was seen for women who had greater than or equal to 4 visits per year comp ared to women with < 4 visits (RR = 4.6; CI = 4.18, 5.06). On average, women in the screened population had fewer emergency room visits and more primary care and specialty clinic visits compared to the nonscree ned population. Reducing the cost of mammography to the patient and pr oviding systems for physician referral from hospital-based settings (e mergency rooms, specialty clinics) may help increase the number of low -income and minority women who obtain screening mammograms. Medical Su bject Headings (MeSH): mammography, screening, community health center , low-income, minority.