Language and use of cancer screening services among border and non-border Hispanic Texas women.
OBJECTIVE
Compared to other groups, Mexican American women screen less frequently for cervical and breast cancer. The most significant barriers reported by previous researchers include not having a usual source of care, lacking health insurance and English-language difficulties. In this paper we document and examine the factors associated with disparities in cancer screening between border and non-border residents by language of interview (Spanish or English) among Texas Hispanic women. We hypothesize that, controlling for socioeconomic and demographic characteristics, border residents are more likely to utilize screening services than non-border residents because of the greater presence of bilingual services in border counties.


METHODS
We follow the framework of the Behavioral Model for Vulnerable Populations proposed by Gelberg et al. (Health Services Research, vol. 34, no. 6, pp. 1273-1302, 2000). This model conceptualizes use of health care as an outcome of the interplay of predisposing, enabling and need factors and recognizes that vulnerable groups face additional barriers to health care utilization. Data come from the 2000, 2002 and 2004 Texas Behavioral Risk Factor Surveillance surveys.


RESULTS
Group differences in cancer screenings are explained largely by socioeconomic characteristics and structural barriers to access. The significance of language of interview and of border residence disappear after controlling for factors such as health insurance, income and a usual source of care.


CONCLUSIONS
Women who selected to be interviewed in Spanish were less likely to report age-appropriate cancer examinations, health insurance and a regular health care provider than those who selected to be interviewed in English. Disparities in cancer screenings among vulnerable Hispanic populations could be reduced by promoting the establishment of a regular health care provider.
Fernández
Leticia E
LE
letfernandez@utep.edu
Morales
Alfonso
A
D000328:Adult; D000367:Age Factors; D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D003144:Communication Barriers; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007802:Language; D008327:Mammography / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000208:ethnology; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010808:Physical Examination / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears / Q000706:statistics & numerical data*