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APHA Scientific Session and Event Listing

Recorded presentation

Melissa Gatchell, MPH, Health Services, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772, 310-206-4021, gatchell@ucla.edu and Ninez Ponce, MPP, PhD, Department of Health Services, UCLA, 31-254B CHS, Los Angeles, CA 90095-1772.

Background: Low-income women face significant barriers to accessing care. Discrimination may contribute to these barriers. Objective: To examine whether discrimination is associated with lower likelihood of Pap test among women enrolled in Medicaid. Data/Methods: 2001 California Health Interview Survey. Outcome is receipt of a Pap test within the previous 3 years, for women age 18+ (U.S. Preventive Services Task Force guidelines). Discrimination is based on the question: “Thinking of your experiences with receiving health care in the past 12 months, have you felt you were discriminated against for any reason?” Study included only women, age 18-64, reporting a doctor visit in the previous 2 years. Analyses: 1) Logistic regression of insurance on discrimination, controlling for marital status, health status, English proficiency, education, citizenship, poverty, residence, race/ethnicity, age, number of doctor visits, and insurance (n=25,401) and 2) logistic regression of discrimination on screening for women enrolled in Medicaid, controlling for the above covariates (n=3,309). Results: Women with Medicaid coverage were significantly more likely to report discrimination in the receipt of care than women with employer-based coverage (OR=1.67, 95%CI=1.28-2.16). Among women enrolled in Medicaid, 10.2% reported discrimination: Whites(14.3%), Latinos(7.3%), Asians(6.9%), African Americans(11.3%) and 85.9% reported screening. This is compared to rates among women with the following types of coverage: private(85.7%), employer-based(89.0%), and uninsured(74.9%). Self-reported discrimination was not associated with cervical cancer screening for women enrolled in Medicaid. Conclusion: Despite no association, self-reported discrimination remains high for many groups and screening rates among women enrolled in Medicaid remain relatively low.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Understand the current body literature on discrimination and health.
• Assess the impact of discrimination on access to health care.
• Discuss the ramifications of such research and understand the avenues for future research in this area.

Keywords: Access to Care, Cervical Cancer

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation