Preventive Medicine
Volume 39, Issue 5, 2004, Pages 943-950

The role of health insurance on Pap smear and mammography utilization by immigrants living in the United States (Article)

Carrasquillo O.* , Pati S.
  • a Division of General Medicine, Columbia University, College of Physicians and Surgeons, 622 West 168th Street, New York, NY 100032, United States
  • b [Affiliation not available]

Abstract

Background. Nearly half of recent immigrants to the United States lack health insurance. Access to cancer screening services for this group is problematic. We examine the role of health insurance and having a usual source of care (USC) on Pap smear and mammography utilization by immigrant women using a nationally representative sample. Methods. We used a telephone survey that oversampled racial and ethnic minorities. We analyzed data on 3,622 women age 18-70. We classified the 822 foreign-born women as recent immigrants if they had resided in the United States for under 10 years; LT immigrants were those with a longer tenure. Results. Among recent immigrants, 73% and 78% (SE 4%) reported a Pap smear or mammogram, respectively, in the previous 2 years versus 89% and 89% of U.S.-born women (P < 0.05 for both comparisons). Among those with insurance or a USC, differences in screening between recent immigrants and U.S.-born women were four percentage points or less and not statistically significant. However, uninsured recent immigrants were less likely than uninsured U.S.-born women to have Pap smears [60% (SE 7%) versus 71%, P < 0.05]. Adjusting for differences in sociodemographics, health attitudes or beliefs, patient or provider communication, and the medical care environment, insurance remained the strongest predictor of screening. Conclusion. Disparities in screening were greatly attenuated among the insured population. Increasing awareness of available safety net sources of care may also improve cancer screening among uninsured recent immigrants. © 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.

Author Keywords

mammography Ethnic groups Vaginal smears Insurance Hispanic Americans Emigration and immigration

Index Keywords

Vaginal Smears immigrant medically uninsured Health Care Surveys demography race difference health insurance interpersonal communication human middle aged ethnic group controlled study priority journal Aged Insurance, Health statistical significance United States Humans Mammography attitude Adolescent female prediction Socioeconomic Factors Multivariate Analysis Article Telephone health care awareness adult data analysis Papanicolaou Test Emigration and Immigration medical care Health Services Accessibility time health survey

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-4744360563&doi=10.1016%2fj.ypmed.2004.03.033&partnerID=40&md5=1e9bf84fdf2df42e00565aa00300dff3

DOI: 10.1016/j.ypmed.2004.03.033
ISSN: 00917435
Cited by: 93
Original Language: English