201779 Role of race/ethnicity in Pap-test utilization: A case-control study

Tuesday, November 10, 2009

Bertha Hidalgo, MPH , Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Isabel Scarinci, PhD, MPH , Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Gerald McGwin, MS, PhD , Department of Epidemiology, School of Public Health, University of Alabama, Birmingham, Birmingham, AL
OBJECTIVES: To identify factors associated with underutilization of the Pap test, focusing on the differences existing between Latinas and other racial/ethnic groups and between U.S. and foreign-born Latinas.

METHODS: The data for this analysis was obtained from the 2003 Medical Expenditure Panel Survey. Study participants included females 18-64 years of age who reported never having had a hysterectomy. Women who had a Pap test ≤ 5 years, > 5 years ago, and those who had never had a Pap test were compared to those with a recent Pap test (≤3 years). Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between underutilization and race/ethnicity.

RESULTS: The analysis showed that underutilization was associated with being Latina (OR 1.35, 95% CI 1.11-1.64) and Asian (OR 2.26, 95% CI 1.68-3.03); lack a usual source of health care (OR 2.47, 95% CI 2.10-2.90); and low-income status (OR 2.00, 955 CI 1.53-2.35). Comparing U.S. versus foreign-born Latinas, underutilization was 1.6-times (95% CI 1.34-1.93) more likely for non-U.S. born, having no usual source of care (OR 2.08, 95% CI 1.62-2.67) and having low income status (OR 1.98, 1.18-3.31).

CONCLUSIONS: Racial/ethnic disparities continue to exist in Pap-test utilization. Among Latinas, nativity affected utilization. It is therefore important to continue to address these disparities with interventions and healthcare policies aimed at addressing these issues. These results also highlight the importance of addressing health outcome disparities in future research.

Learning Objectives:
Assess the association between Pap-test utilization and race/ethnicity.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: BA in Human Biology from Stanford University; MPH in EPidemiology/Biostatistics from the University of Southern California; currently undergoing PhD studies in Epidemiology at the University of Alabama, Birmingham.
Any relevant financial relationships? No

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.