Details:

Alternative Title:
Prev Chronic Dis
Publisher's site:
http://dx.doi.org/10.5888/pcd15.170267
Personal Author:
Heintzman, John ; Hatch, Brigit ; Coronado, Gloria ; Ezekiel, David ; Cowburn, Stuart ; ... More +
Heintzman, John ; Hatch, Brigit ; Coronado, Gloria ; Ezekiel, David ; Cowburn, Stuart ; Escamilla-Sanchez, Octavio ; Marino, Miguel Less -
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.


Subject:
[+]
Adult
Aged
Community Health Centers
Female
Health Status Disparities
Hispanic Americans
Humans
Longitudinal Studies
Mass Screening
Medically Uninsured
Middle Aged
Odds Ratio
Papanicolaou Test
Papillomavirus Vaccines
Poverty
Retrospective Studies
Uterine Cervical Neoplasms
Vaccination

Source:
Prev Chronic Dis. 15.
Pubmed ID:
29470167
Pubmed Central ID:
PMC5833315
Document Type:
Journal Article
Place as Subject:
Oregon
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:c7fe349e06052141125a73d0436791d7f763e1368ef529983de20f3a9dabbec2
File Type:

Supporting Files

• 	PCD-15-E25.nxml	xml
  	PCD-15-E25s01.gif	gif
  	PCD-15-E25s01.jpg	jpeg

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