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APHA Scientific Session and Event Listing
4217.0: Tuesday, November 06, 2007 - 3:05 PM

Abstract #156789

Impact of Length of U.S. Residence and Health Insurance on Receipt of Mammograms Among Vietnamese-American Immigrants

Gem Le, MHS1, Stephen J. McPhee, MD2, Ginny Gildengorin, PhD3, Tung Nguyen, MD4, Thoa Nguyen4, and Janice Tsoh, PhD5. (1) Department of Epidemiology, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94720, 5104204593, Gem@berkeley.edu, (2) Vietnamese Community Health Promotion Project, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, UCSF Box 0320, 400 Parnassus Ave., A447, San Francisco, CA 94143, (3) Department of Medicine, University of California, San Francisco, 3333 California Street, San Francisco, CA 94143-0856, (4) Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 400 Parnassus Ave., San Francisco, CA 94143-0320, (5) Department of Psychiatry, UCSF, 401 Parnassus Ave. (0984-TRC, San Francisco, CA 94143

Background: Although breast cancer is the leading cancer among Vietnamese American women, rates of screening in this population are low. Few studies have examined the relationship between their length of U.S. residence, health insurance, and mammography receipt.

Methods: Prior to a community-wide intervention to improve breast cancer screening, we conducted baseline telephone surveys among randomly selected Vietnamese-American women age ≥ 40 living in Santa Clara County, CA and Harris County, TX. Multivariate logistic regression analyses examined the relationship between length of U.S. residence, health insurance, and ever receiving mammography for recent (≤ 10 years), semi-recent (11-19 years), and long-term (≥ 20 years) immigrants.

Results: Among 1,214 foreign-born respondents (mean age = 55.9 years), 30% were recent, 38% semi-recent, and 32% long-term immigrants (p<.0001). Recent immigrants had a lower rate of mammography (73%) than semi-recent (84%) and long-term (87%) immigrants. After adjusting for site, socioeconomic factors, and physician characteristics, semi-recent and long-term immigrants were more likely to have ever had mammography (OR = 1.6, 95% CI, 1.1-2.4 and OR = 1.9, 95% CI, 1.2-3.0, respectively) compared to recent immigrants. Further adjustment for health insurance only slightly attenuated the relationship between length of U.S. residence and mammography, decreasing the odds ratio to 1.5 (95% CI, 1.0-2.3) in semi-recent immigrants and to 1.8 (95% CI, 1.1-2.8) in long-term immigrants.

Conclusion: Recent immigrants were least likely to have ever received mammography regardless of health insurance status. Outreach efforts need to target recent immigrants and explore cultural, psychological, and social barriers to mammography receipt.

Learning Objectives:

Keywords: Breast Cancer Screening, Access Immigration

Related Web page: www.healthisgold.org

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Cancer Screening

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA