Screening mammography in southeastern Kentucky: Is it a predictor of ongoing health disparities?

Abstract

28 Background: Studies have shown that women living in rural areas have a significantly lower rate of screening mammography than women living in urban areas. Despite the dramatic improvement in the use of screening mammography in the United States, disparities are still present. Southeastern Kentucky is a rural area with a low income population and barriers such as distance and lack of public transportation to access health care. We reviewed the use of screening mammography in this population. Methods: Data for women age 50 and older who did not have a screening mammography within the past 2 years were obtained from the behavioral risk factor surveillance system for the years 2000 through 2008. Results: The rates of screening mammography in the state of Kentucky for women age 50 and older ranged from 77% in 2000 to77.6% in 2008. The rates for urban areas in Kentucky ranged from 79.5% in 2000 to 79.4% in 2008 and those for the rural southeastern part of the state ranged from 62.6 % in 2000 to 63.7 in 2008. On average, the rates of screening mammography in southeastern Kentucky were 23% lower than state rates from 2000-2008, a difference that is statistically significant (p<.05). Additionally, from 2000 to 2008 there was no statistically significant improvement in the rates of screening mammography in southeastern Kentucky. Conclusions: The results of this study showed that the rates of participation in screening mammography are substantially lower in rural southeastern Kentucky. Continued efforts are needed to improve understanding the factors that contribute to these low rates and to help develop interventions to overcome the obstacles for obtaining screening mammography in rural populations.