SOCIAL SUPPORT AND CANCER SCREENING AMONG OLDER BLACK-AMERICANS

Background: Age-adjusted cancer mortality is 27% higher for Black Amer icans than for the general U.S. population, which may result from inap propriate use of cancer detection tests. Social support has been shown to affect adjustment to breast cancer and survival, but it has not be en studied as a predictor of use of preventive health care services in the older population. Our hypothesis is that larger social networks a re associated with greater utilization of cancer-screening tests in th e older population. Purpose: The objective of this study was to examin e the relationship between social support and use of cancer-screening tests among older Black Americans. Methods: Data for this study were o btained from a 1986 baseline survey evaluation of a community interven tion program to increase cancer awareness and a 1991 end-point survey of use of cancer detection tests. Our study sample consisted of 617 Bl ack Americans aged 55 years or older who lived in San Francisco (Calif .), the control community, and in Oakland (Calif.), the target communi ty for intervention. The survey included measures of 1) social network characteristics, as determined by a modified version of Berkman and S yme's Social Network Index; 2) demographic characteristics; and 3) use of six cancer-screening tests-mammography, occult blood stool cervica l smear, clinical breast examination, digital rectal examination, and sigmoidoscopy. Results: Multiple logistic regression analysis of the S ocial Network Index results indicated statistically significant positi ve associations of social support with the use of mammography and occu lt blood stool examination but not with the other cancer-screening tes ts. There were statistically significant associations between having H MO (Health Maintenance Organization) insurance and increased use of ma mmography and occult blood stool examination, compared with having Med i-Cal or other insurance. The interval between the surveys had a stati stically significant positive association with use of mammography. The se significant associations were not explained by differences in the o ther variables, which included health status, age, gender, education, type of health insurance, interval between the surveys, and a regular source of care. Conclusions: Social support seems to be associated wit h increased use of mammography and occult blood stool examinations amo ng older Black Americans. Implications: Interventions designed to incr ease utilization of social networks may be an effective way to increas e use of cancer screening, which may ultimately lead to reduced mortal ity from cancer.