Rural racial disparities and barriers in mammography utilization among Medicare beneficiaries in Texas: A longitudinal study.
Zhaoli Liu, Yong Shan, Yong-Fang Kuo and 1 others
PMID 37967477WHAT IT FOUND
Rural Hispanic and Black women aged 65-74 were significantly less likely to keep up with mammograms than urban peers, even after accounting for income and health.
Having a regular primary care provider was the strongest predictor of staying screened.
Key findings
01Hispanic women had the lowest rate of regular mammography screening (31.06%) compared to Non-Hispanic Black (43.57%) and Non-Hispanic White (43.76%) women.
02After adjusting for covariates, rural Hispanic and rural Non-Hispanic Black beneficiaries were 33% and 22% less likely to have regular screening than their urban counterparts, while no significant difference existed for Non-Hispanic White beneficiaries.
03Beneficiaries with an established primary care provider were 3.31 times more likely to be regular users of mammography compared to those without one.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used only pre-pandemic data, so it does not reflect changes in screening practices due to COVID-19 or associated policy shifts. Findings are based on Texas Medicare beneficiaries with fee-for-service plans, so they may not generalize to other states, age groups, or those with HMO coverage. Socioeconomic status was measured at the county level rather than the individual level, which may not capture personal financial barriers. Mammography utilization was derived from claims data, which can contain errors or omissions regarding whether a screening actually occurred.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Cancer Institute (NIH) and the National Institute on Minority Health and Health Disparities (NIH).
The easy way to misread this
Do not assume that rural residence alone causes lower screening rates for all women. The study found no significant overall rural-urban difference after adjusting for covariates; the disparity was specific to rural Hispanic and Black women compared to their urban counterparts, suggesting race and geography interact rather than geography acting alone.