Use of USPSTF Prevention and Screening Services among Working-Age and Older Adults with Disabilities

Background: This study examines potential disparities among working-age (i.e., 18-64) and older adults (i.e., 65+) with disabilities in their receipt of US Preventive Services Task Force (USPSTF) screening measures. Methods: We pool data from five panels of the Medical Expenditure Panel Survey. Following Andersen's Behavioral Model of Health Care Access, we model measures of use (e.g., blood pressure screening, mammography) as functions of predisposing (e.g.., race, ethnicity, age, gender), enabling (i.e., income, usual source of care), need (i.e., presence of a disability) and contextual (e.g., MSA) factors. We examine models by age and test whether the occurrence of screening activities differs by age. Findings: On most measures, individuals with disabilities were more likely to receive the service than those without disabilities; this finding held across age groups. Working-age and older women with disabilities were less likely to receive a recommended pap smear. While working-age women with disabilities were no more or less likely to receive a clinical breast examination or mammogram than women without a disability, older women with disabilities were significantly less likely to receive these services. A usual source of care was strongly related to receipt of screening services, and evidenced a larger effect on older adults' receipt of services. Discussion and Implications: Financial support for USPSTF A and B recommended services under the Affordable Care Act may reduce the disparities we observed for women with disabilities. Research exploring the effects of factors such as patient-provider interactions and gender concordance on disparities among women with disabilities is warranted.