Socioeconomic status and access to health care are the most significant social determinants hindering breast cancer screening among women aged 40 and older in the United States, according to a new study from Florida Atlantic University’s Schmidt College of Medicine.
The scoping review, published in Frontiers in Public Health, analyzed 72 peer-reviewed observational studies from 2013 to 2023. It found that factors related to socioeconomic status, including income, education level, and employment status, were most frequently associated with low screening rates.
Access to health care emerged as a statistically significant theme in 61 percent of the studies, with insurance status being the most reported sub-category. Many studies demonstrated a strong link between lack of health insurance and lower breast cancer screening rates.
Race and ethnicity also played a crucial role. Ethnic minority women, except those identifying as Asian, had a lower likelihood of being screened. Black women faced a higher risk of diagnosis upon first screening.
“One of the most influential roles of social determinants of health lies within the realm of equitable access,” said Dr. Lea Sacca, senior author and assistant professor at FAU.
The study highlighted disparities in screening rates based on income levels. Women with estimated household incomes above $38,100 had higher rates of repeat mammography compared to those below $25,399.
Food insecurity was another influential factor. “Women facing food insecurity have a 54 percent lower likelihood of getting a mammogram,” Sacca noted.
Researchers suggest that improving patient-provider communication, addressing perceived discrimination, and enhancing trust in the healthcare system could help improve screening rates across all demographics.
See “Study Underscores Social Factors of Low Breast Cancer Screening in the U.S.” (March 4, 2024)
