Does gender discrimination impact regular mammography screening? Findings from the race differences in screening mammography study.
ABSTRACT Objective: To determine if gender discrimination, conceptualized as a negative life stressor, is a deterrent to adherence to mammography screening guidelines.


METHODS
African American and white women (1451) aged 40-79 years who obtained an index screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998 were enrolled in this study. This logistic regression analysis includes the 1229 women who completed telephone interviews at baseline and follow-up (average 29.4 months later) and for whom the study outcome, nonadherence to age-specific mammography screening guidelines, was determined. Gender discrimination was measured as lifetime experience in seven possible situations.


RESULTS
Gender discrimination, reported by nearly 38% of the study population, was significantly associated with nonadherence to mammography guidelines in women with annual family incomes of > or =$50,000 (OR 1.99, 95% CI 1.33, 2.98) and did not differ across racial/ethnic group.


CONCLUSIONS
Our findings suggest that gender discrimination can adversely influence regular mammography screening in some women. With nearly half of women nonadherent to screening mammography guidelines in this study and with decreasing mammography rates nationwide, it is important to address the complexity of nonadherence across subgroups of women. Life stressors, such as experiences of gender discrimination, may have considerable consequences, potentially influencing health prevention prioritization in women.
Dailey
Amy B
AB
Department of Epidemiology and Biostatistics, University of Florida College of Public Health and Health Professions, Gainesville, Florida 32610, USA. abdailey@phhp.ufl.edu
Kasl
Stanislav V
SV
Jones
Beth A
BA
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D011287:Prejudice; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*