Education and income differentials in breast and cervical cancer screening - Policy implications for rural women
Education and income differentials in breast and cervical cancer screening - Policy implications for rural women
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DOI：
10.1097/00005650-199703000-00004
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发表时间：
1997-03-01
期刊：
影响因子：
3
通讯作者：
House, JS
中科院分区：
文献类型：
--
作者：
Lantz, PM;Weigers, ME;House, JS
目标。尽管有大量证据表明乳腺癌和宫颈癌筛查的使用存在社会经济差异，但解释这些差异的机制以及它们的政策含义还没有被很好地理解。我们调查了教育和收入对农村妇女使用乳房X光检查和巴氏检查的影响，包括获得医疗保健的经济障碍、知识和态度障碍，以及与获得医疗保健相关的非经济因素。方法：数据来自对威斯康星州2346名40岁及以上农村妇女的电话调查。我们进行了Logistic回归分析和模拟实验。结果：在这一农村人口中，筛查的最大障碍是获得筛查的非经济障碍。当存在其他类型的障碍时，消除经济障碍并没有导致筛查的显著增加。结论：专注于不同社会经济水平的农村妇女之间存在的最明显差异的政策和干预措施(即，负担医疗服务的能力差异)，而不是同时解决知识、态度和医疗保健获得障碍，将达不到增加乳腺癌和宫颈癌筛查的目标。
OBJECTIVES. Despite substantial evidence of socioeconomic differences in the use of breast and cervical cancer screening, the mechanisms explaining these differences, and therefore their policy implications are not well understood. We investigated the way that education and income influence rural women's use of mammograms and Pap tests, including financial barriers to medical care, knowledge and attitudinal barriers, and nonfinancial factors related to health-care access.METHODS. Data were from a population-based telephone survey of 2,346 rural Wisconsin women aged 40 years and older. Logistic regression analyses and simulation exercises were conducted.RESULTS. The strongest barriers to screening in this rural population were nonfinancial impediments to access. Removing economic barriers did not lead to significant increases in screening when other types of barriers were present.CONCLUSIONS. Policies and interventions that focus on the most visible differences that exist between rural women of differing socioeconomic levels (ie, differences in the ability to afford health services) and do not simultaneously address knowledge, attitudinal, and health-care access barriers will fall short of their goal to increase breast and cervical cancer screening.