Role of Race/Ethnicity, Language, and Insurance in Use of Cervical Cancer Prevention Services Among Low-Income Hispanic Women, 2009–2013

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Heintzman, John ; Hatch, Brigit ; Coronado, Gloria ; Ezekiel, David ; Cowburn, Stuart ; Escamilla-Sanchez, Octavio ; Marino, Miguel
• Description:
  Introduction
  
  Hispanic women in the United States have an elevated risk of cervical cancer, but the existing literature does not reveal why this disparity persists.
  
  Methods
  
  We performed a retrospective cohort analysis of 17,828 low-income women aged 21 to 64 years seeking care at Oregon community health centers served by a hosted, linked electronic health record during 2009 through 2013. We assessed the odds of having had Papanicolaou (Pap) tests and receiving human papillomavirus (HPV) vaccine, by race/ethnicity, insurance status, and language.
  
  Results
  
  Hispanic women, regardless of pregnancy status or insurance, had greater odds of having had Pap tests than non-Hispanic white women during the study period. English-preferring Hispanic women had higher odds of having had Pap tests than Spanish-preferring Hispanic women (OR, 2.08; 95% confidence interval [CI], 1.63–2.66) but lower odds of having received HPV vaccination (OR, 0.21; 95% CI, 0.12–0.38). Uninsured patients, regardless of race/ethnicity, had lower odds of HPV vaccine initiation than insured patients did. Once a single dose was received, there were no significant racial/ethnic differences in vaccine series completion.
  
  Conclusion
  
  In this sample of low-income women seeking care at Oregon community health centers, we found minimal racial/ethnic disparities in the receipt of cervical cancer prevention services. Inequities by insurance status, especially in the receipt of HPV vaccine, persist. Community health center–based care may be a useful model to address racial/ethnic disparities in prevention, but this model would need further population-wide study.
  
  
• Subjects:
  Adult Aged Community Health Centers Female Health Status Disparities Hispanic Or Latino Humans Longitudinal Studies Mass Screening Medically Uninsured Middle Aged Odds Ratio Papanicolaou Test Papillomavirus Vaccines Poverty Retrospective Studies Uterine Cervical Neoplasms Vaccination

  More +
• Source:
  Prev Chronic Dis. 15.
• DOI:
  http://dx.doi.org/10.5888/pcd15.170267
• ISSN:
  1545-1151
• Pubmed ID:
  29470167
• Pubmed Central ID:
  PMC5833315
• Document Type:
  Journal Article
• Place as Subject:
  Oregon
• Location:
  North America
• Volume:
  15
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:6c751e6b45b6b606828eba9e8170744b372f79e4b016f9b16d0b69f235b9e6b0d357498cffc1d965f9f73bafba59505c5fcc64764c78ff0b0360c26585a1d1b4
• Download URL:
  https://stacks.cdc.gov/view/cdc/52784/cdc_52784_DS1.pdf
• File Type:
  [PDF - 301.40 KB ]