156789 Impact of Length of U.S. Residence and Health Insurance on Receipt of Mammograms Among Vietnamese-American Immigrants

Tuesday, November 6, 2007: 3:05 PM

Gem Le, MHS , Department of Epidemiology, University of California, Berkeley, Berkeley, CA
Stephen J. McPhee, MD , Vietnamese Community Health Promotion Project, Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Ginny Gildengorin, PhD , Department of Medicine, University of California, San Francisco, San Francisco, CA
Tung Nguyen, MD , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Thoa Nguyen , Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA
Janice Tsoh, PhD , Department of Psychiatry, UCSF, San Francisco, CA
     
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:
1. Recognize breast cancer as the leading cancer among Vietnamese women. 2. Analyze the effect of health insurance among Vietnamese immigrant women based on their length of residence in the U.S. 3. Prioritize the need for outreach to recent immigrants to improve access to mammography screening.

Keywords: Breast Cancer Screening, Access Immigration

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.

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