Factors associated with screening mammography in low-income women.

Despite its effectiveness as a preventive measure, studies indicate that low-income and minority women are less likely to obtain screening mammograms than other groups. Using a logistic regression model to adjust for multiple variables, we examined factors associated with women age > or = 40 years of age who obtained a screening mammogram in a community health center setting from 1990 to 1991 (screened, n = 3,521; nonscreened, n = 7,461). Women 50-64 were more likely to be screened than women 40-49 (adjusted relative risk [RR] = 1.57; 95% confidence interval [CI] = 1.42, 1.73). Native American, Asian, and women of other races were less likely to be screened than Caucasian, African-American, or Hispanic women (adjusted RR = 0.66; CI = 0.51, 0.87). Women on Medicaid were twice as likely to be screened than women who received no subsidized care (adjusted RR = 1.99; CI = 1.68, 2.35). Women who received the majority of their care at a community-based health clinic were twice as likely to be screened than women who received care primarily at a hospital-based ambulatory care site (adjusted RR = 2.34; CI = 2.06, 2.65). The greatest difference in adjusted RR was seen for women who had > or = 4 visits per year compared to women with < 4 visits (RR = 4.6; CI = 4.18, 5.06). On average, women in the screened population had fewer emergency room visits and more primary care and specialty clinic visits compared to the nonscreened population. Reducing the cost of mammography to the patient and providing systems for physician referral from hospital-based settings (emergency rooms, specialty clinics) may help increase the number of low-income and minority women who obtain screening mammograms. Medical Subject Headings (MeSH): mammography, screening, community health center, low-income, minority.