title: Low income, race, and the use of mammography.
abstract: OBJECTIVE
  To describe national trends in mammography use by race and income and to test whether higher use of mammography among low-income African American women than low-income white women can be explained by health insurance coverage, usual place of health care, or place of residence.
  
  
  METHODS
  Data from five years of the National Health Interview Survey spanning the period 1987-1994.
  
  
  METHODS
  Trends in the percentage of women 50-64 years of age with a mammogram within the past two years were analyzed by race and income. Data for 1993-1994 were pooled, and with logistic regression analysis, variation in use of recent mammography for low-income women was investigated. Independent variables are age, race, family income, education, health insurance coverage, place of usual source of health care, metropolitan residence, and geographic region.
  
  
  METHODS
  The National Health Interview Survey is a cross-sectional national survey conducted by the National Center for Health Statistics. Data are collected through household interviews. [Editor's note: in keeping with HSR policy, the term black is used to conform to its use in the surveys studied. In other references to race, the term African American is used.]
  
  
  RESULTS
  Among women 50-64 years of age use of recent mammograms increased rapidly between 1987 and 1991 for all groups of women, and between 1991 and 1994 the increases slowed. However, increases between 1991 and 1994 have been more rapid among low-income black women than among low-income white women. In 1993-1994, low-income black women were about one-third more likely than low-income white women to report mammography within the past two years. This difference could not be explained by health insurance coverage, usual source of health care, metropolitan status, or region of residence.
  
  
  CONCLUSIONS
  These results, which provide some evidence of success for screening programs targeted to the poor, raise the question of why low-income black women appear to be to more likely than low-income white women to have benefited from recent efforts to promote mammography. Continued evaluation of mammography programs focused on women who are underserved as well as the monitoring of trends and variations in service use by race and income are needed.
authors: Division of Health and Utilization Analysis, National Center for Health Statistics/CDC, Hyattsville, MD 20782, USA.
authors: D M
authors: DM
authors: Makuc
authors: N
authors: N
authors: Breen
authors: V
authors: V
authors: Freid
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000706:statistics & numerical data; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D011203:Poverty / Q000208:ethnology* / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data*