Comparison of racial/ethnic disparities in adult immunization and cancer screening

Karen A. Lees, Pascale M. Wortley, Steven Scott Coughlin

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Background: Racial/ethnic disparities in adult influenza and pneumococcal vaccination are marked and poorly understood. The purpose of this study was to contrast these disparities with disparities in other clinical preventive services - mammography and colorectal cancer screening - that are targeted to older populations. Methods: Data from the 2000 National Health Interview Survey were analyzed in 2004 to determine to what degree race/ethnicity remains a predictor of the receipt of each service after adjusting for personal and health characteristics, socioeconomic status (SES), and access to and utilization of care variables. Results: Blacks and Hispanics were significantly less likely to report receipt of nearly all preventive services examined. Among whites, 57%, 67%, 67%, and 40% reported pneumococcal vaccination, influenza vaccination, mammography, and colorectal cancer screening, respectively. Among blacks, those proportions were 31%, 48%, 60% and 33%, respectively; among English-speaking Hispanics, 35%, 60%, 60%, and 30%, respectively; and among Spanish-speaking Hispanics, 24%, 49%, 52%, and 19%, respectively. After adjusting for personal and health characteristics, socioeconomic factors, and measures of access to and utilization of care, blacks and English- and Spanish-speaking Hispanics remained significantly less likely than whites to report the receipt of pneumococcal vaccination; blacks remained significantly less likely to report influenza vaccination than whites; and Spanish-speaking Hispanics remained significantly less to report colorectal cancer screening than whites. Conclusions: Most racial/ethnic disparities seen in breast and colorectal cancer screening are explained by differences in SES. In contrast, racial/ethnic disparities in adult immunization persist, and especially for pneumococcal vaccination, suggesting that different barriers may be involved.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalAmerican Journal of Preventive Medicine
Volume29
Issue number5
DOIs
Publication statusPublished - Dec 1 2005
Externally publishedYes

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ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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