Do disparities exist in preventive and surveillance care utilization among older women? findings from a national population-based study

Objective: Research has shown that preventive care can reduce the risk of morbidity and mortality related to chronic disease conditions. We sought to understand the influence of household income, education, house ownership, and economic hardship on the use of preventive and surveillance care among older women in Taiwan. Methods: Data on this study for 2932 older women aged 53 and above were drawn from the eight-year longitudinal national representative sample in Taiwan. Measures of preventive care were influenza vaccination, blood cholesterol and blood glucose tests within the previous year. Surveillance care included mammography and Pap smear within the previous year. Multivariate logistic regression and generalized estimating equations were used to estimate associations between socioeconomic factors and the use of preventive and surveillance care, controlling for individual demographic variables, social support, and health status. Results: Preliminary results show that household income is strongly related to the use of Pap smear, mammography, and blood cholesterol tests. There are significant associations of perceived economic hardship with less use of Pap smear, blood cholesterol and blood glucose tests, but not with mammography and influenza vaccination. Additionally, older women with house ownership reported more influenza vaccination utilization. Higher education levels are associated with more use of Pap smear. Conclusions: These findings underscore that socioeconomically disadvantaged women may make less use of healthcare services. Despite the presence of national health insurance coverage in Taiwan, the disparities in the preventive and surveillance care utilization still exist.