Use of screening and preventive services among women with disabilities.
Roughly 54 million Americans have some disability; at older ages, women are more likely to be disabled than men. Many people with disabilities today live virtually normal life spans, and therefore routine screening and preventive services are essential to their overall quality of care. We used the 1994-1995 National Health Interview Survey (NHIS), with Disability, Family Resources, and Healthy People 2000 supplements, to examine screening and preventive service use for adult women with disabilities living in the community--about 18.4% of women (estimated 18.28 million). Disability was associated with higher age-adjusted rates of: poverty; living alone; low education; inability to work; obesity; and being frequently depressed or anxious. Disabled women generally reported screening and preventive services at rates comparable to all women. Women with major lower extremity mobility difficulties had much lower adjusted odds of Papanicolaou smears (odds ratio, 0.6; 95% confidence interval, 0.4-0.9), mammograms (odds ratio, 0.7; 95% confidence interval, 0.5-0.9), and smoking queries (odds ratio, 0.6; 95% confidence interval, 0.5-0.8). Various approaches exist to improve access for disabled women to health care services.
Iezzoni
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Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Charles A. Dana Research Institute, Harvard-Thorndike Laboratory, Boston, Mass., USA. liezzoni@caregroup.harvard.edu
McCarthy
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Davis
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Harris-David
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O'Day
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D000328:Adult; D000368:Aged; D003710:Demography; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D016387:Women's Health