Neighborhood ethnic composition and cancer screening among older Mexican American women

Introduction: Our previous research indicates that Hispanic women living in high concentration areas of Hispanic populations (Latino “barrios”) were more likely to be diagnosed with late-stage breast and cervical cancer. Our research explores the association between ethnic concentration and cancer screening methods in the Hispanic community. Method: Baseline data (1993-1994) from the Hispanic Established Population for the Epidemiologic Study of the Elderly linked to the 1990 US Census; information on screening methods was obtained at 2-year follow-up (1995–1996), on 1,380 Mexican American women aged 67 and over. Outcomes variables were if a woman has ever had a mammogram or a Pap smear. Percent of Mexican Americans at the census tract level [tertiles (1) <67%, (2) 67-88%, (3) >88%] was used as a proxy for neighborhood ethnic concentration. Control variables were percent poor at the census tract level, sociodemographics, medical conditions, and functional status. Results: Prevalence of mammograms and Pap smears were lower in high concentrated Mexican American neighborhoods (p<0.001). In adjusted analyses, Mexican American older women living in high concentrated Mexican American neighborhoods (>88%) were significantly less likely to have a mammogram (OR= 0.67, 95% CI 0.48-0.94) or a Pap smear (OR= 0.63, 95% CI 0.44-0.88) compared to those living in low concentrated Mexican American neighborhoods (<67%). Conclusion: We showed that older Mexican Americans living in ‘barrios' have lower breast and cervical cancer screening rates. Our findings may explain in part why Latinas living in ‘barrios' present with late-stage breast and cervical cancer as reported in previous studies.