Self-reported experience of racism when seeking medical care and adherence to mammography or Pap test screening

Background: Racial disparities in health outcomes are a persistent public health concern. Experiencing racial discrimination when seeking healthcare may negatively impact early detection of breast or cervical cancers.

Objective: We investigated the effect of experiencing racism when seeking healthcare on adherence to mammography or Pap test screening recommendations.

Methods: Our sample included Caucasian and African American women participating in the 2004 Behavioral Risk Factor Surveillance System, who had a known status for mammography and Pap test screening. Women 50+ having had mammography in the past year and women 18+ having had Pap test in the past year were considered adherent to recommendations. Perceived racial discrimination when seeking healthcare was measured with a question in an optional module administered in 7 states and DC. Associations between racism and non-adherence were estimated with odds ratios (OR) and 95% confidence intervals (CI). Confounders including insurance, education, income, and race, were controlled for in the final multivariable logistic regression models.

Results: Among those that reported experiencing racism, 54.2% (mammography) and 64.3% (Pap) were adherent to screening recommendations. In unadjusted analyses, perceived racism was negatively associated with having a recent mammogram (0.72 95% CI: 0.75-1.50) or Pap test (0.85 95% CI: 0.77-1.45). In a model adjusted for socioeconomic indicators the relationship between perceived racism and screening outcomes was no longer significant.

Conclusions: Findings from the multivariable model show that SES indicators and not perceived racism have an important effect on compliance with screening recommendations.