Makuc D M, Breen N, Freid V
Division of Health and Utilization Analysis, National Center for Health Statistics/CDC, Hyattsville, MD 20782, USA.
Health Serv Res. 1999 Apr;34(1 Pt 2):229-39.
To describe national trends in mammography use by race and income and to test whether higher use of mammography among low-income African American women than low-income white women can be explained by health insurance coverage, usual place of health care, or place of residence.
DATA SOURCES/STUDY SETTING: Data from five years of the National Health Interview Survey spanning the period 1987-1994.
Trends in the percentage of women 50-64 years of age with a mammogram within the past two years were analyzed by race and income. Data for 1993-1994 were pooled, and with logistic regression analysis, variation in use of recent mammography for low-income women was investigated. Independent variables are age, race, family income, education, health insurance coverage, place of usual source of health care, metropolitan residence, and geographic region.
DATA COLLECTION/EXTRACTION METHODS: The National Health Interview Survey is a cross-sectional national survey conducted by the National Center for Health Statistics. Data are collected through household interviews. [Editor's note: in keeping with HSR policy, the term black is used to conform to its use in the surveys studied. In other references to race, the term African American is used.]
Among women 50-64 years of age use of recent mammograms increased rapidly between 1987 and 1991 for all groups of women, and between 1991 and 1994 the increases slowed. However, increases between 1991 and 1994 have been more rapid among low-income black women than among low-income white women. In 1993-1994, low-income black women were about one-third more likely than low-income white women to report mammography within the past two years. This difference could not be explained by health insurance coverage, usual source of health care, metropolitan status, or region of residence.
These results, which provide some evidence of success for screening programs targeted to the poor, raise the question of why low-income black women appear to be to more likely than low-income white women to have benefited from recent efforts to promote mammography. Continued evaluation of mammography programs focused on women who are underserved as well as the monitoring of trends and variations in service use by race and income are needed.
描述按种族和收入划分的乳房X光检查使用情况的全国趋势，并检验低收入非裔美国女性比低收入白人女性乳房X光检查使用率更高是否可以通过医疗保险覆盖范围、通常的医疗保健地点或居住地点来解释。
数据来源/研究背景：1987年至1994年期间连续五年的美国国家健康访谈调查数据。
按种族和收入分析了50至64岁女性在过去两年内进行乳房X光检查的百分比趋势。汇总了1993年至1994年的数据，并通过逻辑回归分析研究了低收入女性近期乳房X光检查使用情况的差异。自变量包括年龄、种族、家庭收入、教育程度、医疗保险覆盖范围、通常的医疗保健来源地、大城市居住情况和地理区域。
数据收集/提取方法：美国国家健康访谈调查是由美国国家卫生统计中心进行的一项全国性横断面调查。数据通过家庭访谈收集。[编者注：根据《卫生服务研究》政策，使用“黑人”一词是为了与所研究调查中的用法一致。在其他关于种族的参考文献中，使用“非裔美国人”一词。]
在50至64岁的女性中，所有女性群体在1987年至1991年间近期乳房X光检查的使用率迅速上升，在1991年至1994年间增速放缓。然而，1991年至1994年间，低收入黑人女性的增幅比低收入白人女性更快。在1993年至1994年，低收入黑人女性在过去两年内进行乳房X光检查的可能性比低收入白人女性高约三分之一。这种差异无法通过医疗保险覆盖范围、通常的医疗保健来源、大城市地位或居住地区来解释。
这些结果为针对贫困人口的筛查项目取得的成功提供了一些证据，同时也提出了一个问题，即为什么低收入黑人女性似乎比低收入白人女性更有可能从近期推广乳房X光检查的努力中受益。需要继续评估针对服务不足女性的乳房X光检查项目，并监测按种族和收入划分的服务使用趋势和差异。
