The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61748

Azad A. Kabir, MBBS, MSPH, Tulane Center for Clinical Effectiveness and Prevention, Tulane University Health Science Center, 1430 Tulane Ave TW-38, New Orleans, LA 70112, 504-586-3949, akabir@tulane.edu, H. Giovanni Antunez, MD, MPH, Tulane Hispanic Health Initiative, Tulane Center for Clinical Effectiveness, Tulane University, 1430 Tulane Ave TW - 38, New Orleans, LA 70112, and William C Steinmann, MD, MSc, Center for Clinical Effectiveness and Prevention (TCCEP), Tulane University Health Sciences Center, 1430 Tulane Avenue, TW38, New Orleans, LA 70112.

We used the 1997 to 2000 CDC National Ambulatory Care Survey (NAMCS) and National Hospital Ambulatory Care Survey (NHAMCS) to calculate the proportions of various screening services ordered or provided for non-illness visits in white, black and Hispanic women more than 44 years of age. We evaluated: general health screening services (blood pressure, urinalysis, cholesterol, hematocrit/hemoglobin); and, cancer prevention screening services (breast, pelvic, and rectal exams, Pap test, and mammogram). We considered the complex sampling design to calculate the variance estimates to conduct one tailed Z test to compare the proportions. A total of 122,488,105 women visits (72% white, 14% black, 9% Hispanic), were included in this analysis. Overall white and hispanic women did not differ in the proportion for whom either general or cancer screening services were ordered or provided. Blacks had statistically significant lower proportions (P<0.05) for all cancer prevention services than white and hispanic, but there were no significant differences in general health screening services except higher blood pressure tests than whites (p<.05). Private insurance was associated in whites and hispanics, but not in blacks with higher proportion for most ordered or provided screening services, than was Medicaid/Medicare. Whites and Hispanics, with private insurance, had higher proportion of most screening services than blacks. There were no significant differences by race among Medicaid/Medicare beneficiaries for most of the services. Private insurance is associated with greater screening services than public insurance for white and hispanic women, but not black women. This may account for racial disparity in screening service exposure.

Learning Objectives:

• 1)To understand the racial disparity in women health screening services
• 2)To recognize the most vulnerable women group are black women
• 3)To understand if type of insurance predicts for screening services

Keywords: Women's Health, Health Insurance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.