ASPO Abstracts
Differences in Mammography Utilization according to Car Ownership
Category: Cancer Health Disparities, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
Background: Transportation systems in the US have been vehicle-centered for decades, creating dependency on private vehicles, and possibly creating unequal access to life activities among people who do not own a car. We wanted to identify population groups that are less likely to own a car, and to assess whether car ownership was associated with and potentially mediated the effects of known predictors of mammography use. Methods: We used data from the 2014-15 Survey of the Health of Wisconsin, a population based household examination study to describe demographic differences and patterns of mammography screening use between car owners and non-car owners. We used logistic and proportional odds regression to assess whether car ownership was associated with and mediated the effect of known predictors on the frequency of mammography screening use. Results: Young and old age were strongly associated with lack of car ownership (35 vs. 25 years, OR of owning a car vs. no car 3.42, 95% CI 1.98-5.88; 75 vs. 50 years OR 0.35, 95% CI 0.20-0.61). Incomes above the federal poverty level increased the likelihood that people owned a car (poverty income ratio PIR 300% vs. 100% OR 4.04, 95% CI 2.35-6.93), but with higher incomes the effect plateaued (PIR 800% vs. 500% OR 1.15, 95% CI 0.70-1.88). People without a car had lower education levels, and were less likely to have health insurance. Compared with low-income non-Hispanic whites, low- income racial/ethnic minorities were less likely to own a car. We did not find evidence that car ownership was associated with, or mediated the effect of, known predictors of mammography use. Conclusion: The nonlinear relationships between age, income and car ownership we found confirmed previous work in the field. Our visualizations highlighted a potential interaction between low income and minority status with regards to car ownership. As a healthcare service that is used infrequently, mammography use may not be strongly affected by car ownership either in the general population or among low-income groups, but this is likely context specific and varies regionally in the United States. Future research should focus on vulnerable population groups and access to other more frequent medical services.
Keywords: mammography screening car owndership, race/ethnicity