Recipt of USPSTF Preventive Services among Adults with and without Disabilities

Background: We examine disparities among adults with and without disabilities and their receipt of US Preventive Services Task Force (USPSTF) preventive services. Methods: We pool data from five panels of the Medical Expenditure Panel Survey. Our analytic sample includes approximately 11, 500 respondents age 18-64 who report a disability, following the ICF approach to defining disability. Drawing from Andersen's Behavioral Model of Health Care Access, we model measures of use as functions of predisposing (e.g., race, ethnicity, gender), enabling (e.g., health insurance), need (e.g., presence of a disability) and contextual (e.g., MSA) factors, examining the effect of disability after accounting for covariates. We then include health insurance and a usual source of care and examine the extent to which these enabling factors attenuate potential disparities. Findings: In multivariate logistic models, individuals with disabilities were more likely to receive preventive services than those without disabilities on most measures. Working-age women with disabilities were less likely to receive a recommended pap smear than women without a disability. Working-age women with disabilities were no more or less likely to receive a clinical breast examination or mammogram than women without a disability. Health insurance and a usual source of care were strongly related to receipt of preventive services. Discussion and Implications: Financial support for USPSTF A and B recommended preventive services under the Affordable Care Act may reduce the disparities we observed for women with disabilities. Receipt of screening services was below recommended levels for adults with and without disabilities, warranting additional policy action.