Neighborhood predictors of mammography screening among Latinas in Western Washington

Background. Relatively little is known about if neighborhood contexts are associated with Latina’s mammography practices, despite an abundance of research documenting underutilization of screening among these women and a number of access and psychocultural barriers. 

Objective.Associations between neighborhood characteristics to barriers and plans to obtain a mammogram were examined among non-adherent U.S.-based Latinas.

Methods.As part of a larger study wih Sea Mar clinics, 539 Latinas completed a baseline questionnaire concerning barriers to mammography (cost, embarrassment) and plans to obtain a mammogram. Block group-level characteristics were abstracted from the American Community Survey (2007-2011), including %<HS, %unemployed, % <100% the federal poverty level, and median household income. Latino segregation Gini indices were calculated. Multivariable logistic regressions were conducted on quartiles (Q1-Q4).

Results.Women in higher educated neighborhoods (Q1) were less likely to report cost/access as a barrier relative to women in less educated neighborhoods, ORs for Q2 and Q3 = 0.5, 95%CI [0.3, 0.9], p < .05. Women living in higher educated neighborhoods (Q1) were also more likely to be planning to obtain a mammogram, Q2: OR = 3.0, 95%CI [1.3, 6.6], p = .008; Q3: OR =4.3, 95%CI[1.8, 10.1], p = .008.

Finally, women living in the most segregated neighborhoods (Q4) were more likely to report embarrassment, Q1: OR = 9.6, 95%CI [1.1, 80.7], p = .04. 

Discussion. The type of interventions that may be more effective for women, and Latinas specifically, might depend on their neighborhood characteristics. Future work is warranted to confirm associations and explore underlying mechanisms (e.g., social norms).