Does supply influence mammography screening?
OBJECTIVE
To explain rural-urban differences in mammography screening by supply of health care services.


METHODS
Logistic regression models were used to assess whether variation in the supply of health care services related to mammography screening explained rural-urban differences in mammography screening rates.


RESULTS
Women living in small (thinly populated) rural areas not adjacent to a metro area were less likely to obtain a mammogram (OR = 0.682, CI: 0.62-0.75) compared to women in large metro counties. This difference was reduced after adjusting for predisposing and enabling factors (OR = 0.843, CI: 0.76-0.93).


CONCLUSIONS
Contextual-level enabling factors mediated the rural-urban difference in mammography screening.
Khan
Nasreen
N
College of Pharmacy, University of New Mexico, Albuquerque, NM 87131-0001, USA. nkhan@salud.unm.edu
Kaestner
Robert
R
Salmon
J Warren
JW
Gutierrez
Becky
B
D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D019035:Rural Health Services / Q000600:supply & distribution*; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data