Pap smear rates among Haitian immigrant women in eastern Massachusetts

Autor: Michael A. Posner, Karen M. Freund, Eric H. Green, Michele M. David
Rok vydání: 2005
Předmět:
Gerontology
Health Knowledge
Attitudes
Practice
Cross-sectional study
Immigration
Health Behavior
Uterine Cervical Neoplasms
Health Services Accessibility
0302 clinical medicine
Residence Characteristics
Surveys and Questionnaires
Mass Screening
030212 general & internal medicine
West indies
media_common
High rate
Cervical cancer
Pap smear screening
Emigration and Immigration
Middle Aged
Massachusetts
Educational Status
Female
0305 other medical science
Papanicolaou Test
Research Article
Adult
medicine.medical_specialty
media_common.quotation_subject
Health knowledge
03 medical and health sciences
medicine
Humans
Women
Vaginal Smears
Analysis of Variance
030505 public health
Insurance
Health
Primary Health Care
business.industry
Public health
Public Health
Environmental and Occupational Health
Urban Health
medicine.disease
Haiti
Cross-Sectional Studies
Logistic Models
Socioeconomic Factors
Health Care Surveys
business
Demography
Zdroj: Public health reports (Washington, D.C. : 1974). 120(2)
ISSN: 0033-3549
Popis: Objective. Given limited prior evidence of high rates of cervical cancer in Haitian immigrant women in the U.S., this study was designed to examine self-reported Pap smear screening rates for Haitian immigrant women and compare them to rates for women of other ethnicities. Methods. Multi-ethnic women at least 40 years of age living in neighborhoods with large Haitian immigrant populations in eastern Massachusetts were surveyed in 2000–2002. Multivariate logistic regression analyses were used to examine the effect of demographic and health care characteristics on Pap smear rates. Results. Overall, 81% (95% confidence interval 79%, 84%) of women in the study sample reported having had a Pap smear within three years. In unadjusted analyses, Pap smear rates differed by ethnicity ( p=0.003), with women identified as Haitian having a lower crude Pap smear rate (78%) than women identified as African American (87%), English-speaking Caribbean (88%), or Latina (92%). Women identified as Haitian had a higher rate than women identified as non-Hispanic white (74%). Adjustment for differences in demographic factors known to predict Pap smear acquisition (age, marital status, education level, and household income) only partially accounted for the observed difference in Pap smear rates. However, adjustment for these variables as well as those related to health care access (single site for primary care, health insurance status, and physician gender) eliminated the ethnic difference in Pap smear rates. Conclusions. The lower crude Pap smear rate for Haitian immigrants relative to other women of color was in part due to differences in ( 1) utilization of a single source for primary care, ( 2) health insurance, and ( 3) care provided by female physicians. Public health programs, such as the cancer prevention programs currently utilized in eastern Massachusetts, may influence these factors. Thus, the relatively high Pap rate among women in this study may reflect the success of these programs. Public health and elected officials will need to consider closely how implementing or withdrawing these programs may impact immigrant and minority communities.
Databáze: OpenAIRE
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