THE EFFECTS OF INSURANCE-COVERAGE AND ETHNICITY ON MAMMOGRAPHY UTILIZATION IN A POSTMENOPAUSAL POPULATION

Despite the effectiveness of mammography as a method to detect breast cancer in women ages 50 and older, many women do not obtain screening mammograms. This study used the self-reported mammography history and demographic information obtained during the screening of 2453 postmeno pausal women ages 50 to 79 at the San Diego Women's Health Initiative (WHI) center. We used this data to examine individual and social facto rs that predict mammography use. The WHI center comprised two clinics, one of which focused on Hispanic recruitment and thus provided the op portunity to examine the roles of ethnicity, income, education, marita l status, age, and access to medical services on mammography use. Biva riate analysis indicated that the following factors were all strongly associated with women having had a mammogram in the previous two years : having health insurance, a regular medical provider, an annual house hold income greater than $20,000, and a high-school diploma, as well a s being 65 years or older or white (P < 0.001). Multiple logistic regr ession analysis demonstrated that, when adjusting for all of these fac tors, having a medical provider (P < 0.001) was significant. Having in surance (P = 0.04) was suggestive, but did not meet the multiple-compa risons significance cutoff of P = 0.006. After adjusting for the above factors, it was found that ethnicity was not significant. The results suggest that improved access to a regular provider could increase the use of screening mammography in underserved populations.