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Prev Med. 2017 Sep;102:59-64. doi: 10.1016/j.ypmed.2017.06.024. Epub 2017 Jun 21.

Racial and ethnic disparities among state Medicaid programs for breast cancer screening.

Author information

1
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-76, Atlanta, GA 30341-3717, United States. Electronic address: ftangka@cdc.gov.
2
RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452-8413, United States.
3
School of Public Health and Andrew Young School of Policy Studies, Georgia State University, 1 Park Place, Suite 700, Atlanta, GA 30341, United States.
4
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-76, Atlanta, GA 30341-3717, United States.

Abstract

Breast cancer screening by mammography has been shown to reduce breast cancer morbidity and mortality. The use of mammography screening though varies by race, ethnicity, and, sociodemographic characteristics. Medicaid is an important source of insurance in the US for low-income beneficiaries, who are disproportionately members of racial or ethnic minorities, and who are less likely to be screened than women with higher socioeconomic statuses. We used 2006-2008 data from Medicaid claims and enrollment files to assess racial or ethnic and geographic disparities in the use of breast cancer screening among Medicaid-insured women at the state level. There were disparities in the use of mammography among racial or ethnic groups relative to white women, and the use of mammography varied across the 44 states studied. African American and American Indian women were significantly less likely than white women to use mammography in 30% and 39% of the 44 states analyzed, respectively, whereas Hispanic and Asian American women were the minority groups most likely to receive screening compared with white women. There are racial or ethnic disparities in breast cancer screening at the state level, which indicates that analyses conducted by only using national data not stratified by insurance coverage are insufficient to identify vulnerable populations for interventions to increase the use of mammography, as recommended.

KEYWORDS:

Breast cancer screening; Demographics; Mammography; Medicaid; Morbidity; Mortality; Spatial analysis

PMID:
28647544
PMCID:
PMC5840870
DOI:
10.1016/j.ypmed.2017.06.024
[Indexed for MEDLINE]
Free PMC Article

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