Mammography’s income gradient

Rich women get more regular cancer screening.

Women with more money are healthier, generally, and new data from the CDC shows a strong relationship between income and regular mammography for women over age 49. (The pattern for education is about the same.)

Because Black women have more breast cancer — with worse outcomes on average — than White women, I was expecting a stronger race/ethnicity pattern. Instead, the data show that Black, White, and Asian/Pacific Islander women all have rates over 80%. The exception is American Indian women, only 70% of whom have had the recommended screening.

The big difference is in having health insurance, not surprisingly. Among those with health insurance, screening is 84%; among those without it’s just 56%. And to make matters more rational — and less humane — being married helps, too.

The report concludes:

Health-care reform is likely to increase access by increasing insurance coverage and by reducing out-of-pocket costs for mammography screening. Widespread implementation of evidence-based interventions also will be needed to increase screening rates. These include patient and provider reminders to schedule a mammogram, use of small media (e.g., videos, letters, brochures, and flyers), one-on-one education of women, and reduction of structural barriers (e.g., more convenient hours and attention to language, health literacy, and cultural factors).

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