ASPO Abstracts
Do mobile units increase spatial accessibility to mammography for un-insured women in North Texas?
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose. We investigated whether mobile units increased spatial access to mammography foruninsured women in urban, suburban, and rural North Texas.Methods. We used data from the Breast Screening and Patient Navigation (BSPAN) program,FDA mammography machine location data, and 2011-2016 American Community Survey data. BSPANoffers reduced-cost mammography screening at classic brick-and-mortar facilities anddeploys a complementary mobile unit regionally.We measured access to mammography for uninsured women across 35 counties, using thevariable two-step floating catchment area method. This method evaluates potential accessby using to mammography services as a function of mammography location data and potentiallocal demand, creating local supply-to-demand ratios. We measured supply by linking BPSANproviders to FDA data. To measure demand among uninsured women, we identified Census tractpopulation centroids weighted by insurance status. We assumed: 1 machine could screen14,815 in one year; women do not travel further than 60 minutes for mammography; and womenare more likely to go to closer facilities. We estimated V2SFCA scores using stationaryfacilities only compared to stationarity and mobile facilities combined. Results. Availability of mobile units significantly increased accessibility (p=0.03).Mobile units deployed most often to urban core counties (Dallas and Tarrant; 49.3% ofuses), but also visited 16 counties outside of the urban core. Visual inspection of mappedspatial access scores showed that mobile mammography increased access most in urban corecounties and immediate suburban neighboring counties.Conclusions. Guideline-based screening can decrease morbidity and mortality for breastcancer by identifying cancers earlier, but women may delay or forego screening if theycannot easily access screening facilities. Rural North Texas counties need additionalresources to facilitate mammography for underinsured women. Geospatial analyses can informidentification of optimal locations to facilitate access to mobile mammography screeningfor underinsured populations.
Keywords: spatialaccessibility,breast cancer,mammography, mobilemammography, rural