Use of preventive care by the working poor in the United States.
OBJECTIVE
Examine the association between poverty and preventive care use among older working adults.


METHODS
Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200% of the federal poverty level were defined as poor.


RESULTS
Among 10,088 older working adults, overall preventive care use ranged from 38% (influenza vaccination) to 76% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95% CI, 0.86-0.96), prostate cancer (RR 0.89, 95% CI, 0.81-0.97), and cholesterol screening (RR 0.91, 95% CI, 0.86-0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95% CI, 0.90-1.01) or influenza vaccination (RR 0.92, 95% CI, 0.84-1.01).


CONCLUSIONS
The older working poor are at modestly increased risk for not receiving preventive care.
Ross
Joseph S
JS
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, NY 10029, USA. joseph.ross@mssm.edu
Bernheim
Susannah M
SM
Bradley
Elizabeth H
EH
Teng
Hsun-Mei
HM
Gallo
William T
WT
D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004651:Employment / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006293:Health Promotion; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011203:Poverty / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data