Older Latina women, marital status, and cancer screening

Statement of the problem:

Growing numbers of Latina women are entering their retirement years divorced, widowed, separated, or having never married. Unmarried middle-aged and older Latinas have lower rates of cancer screening than any other group defined by race, ethnicity, and marital status. Research suggests that lower SES, insurance, and lack of a regular doctor partly account for this disparity. CUIDATE ("Take Care!") is an exploratory qualitative study to further elucidate the reasons for the association between marital status and cancer screening among middle-aged and older Latinas in Rhode Island.

Methods:

We used a radio-based recruitment approach to enroll 45 L.E.P. Latinas, stratified by marital status and Caribbean vs. Latin American origin, for in-depth interviews. Photographic prompts were developed to elicit narratives about barriers and facilitators of care. One in three women was also invited to produce photo-narratives of her own. A content analysis method was used to compare married and unmarried women's narratives.

Results:

Previously-married women were similar to currently married women, and never-married women with partners were similar to never-married women without partners. In addition to the expected themes of lower insurance and financial hardship among never-married women, two new themes emerged: (1) Currently- and previously-married Latina women expressed a greater ability and willingness to reach out to their social networks to acquire information and resources; (2) caregiving roles are culturally assigned to never-married adult women, leaving little time or energy for self-care.

Conclusions:

Redressing cancer screening disparities that affect never-married Latina women may require both socio-economic and psychosocial interventions.