title: Area-level socioeconomic position and repeat mammography screening use: results from the 2005 National Health Interview Survey.
abstract: BACKGROUND
  Despite a considerable number of studies describing the relationship between area-level socioeconomic conditions and mammography screening, definitive conclusions have yet to be drawn. The aim of this study was to examine the relationship between area-level socioeconomic position (SEP) and repeat mammography screening, using nationwide U.S. census SEP data linked to a nationally representative sample of women who participated in the 2005 National Health Interview Survey (NHIS).
  
  
  METHODS
  An area-level SEP index using 2000 U.S. census tract data was constructed and categorized into quartiles, including information on unemployment, poverty, housing values, annual family income, education, and occupation. Repeat mammography utilization (dichotomous variable) was defined as having three mammograms over the course of 6 years (24-month interval), which must have included a recent mammogram (in past 2 years). Results were obtained by ordinary multivariable logistic regression for survey data. Women ages 46 to 79 years (n = 7,352) were included in the analysis.
  
  
  RESULTS
  In a model adjusted for sociodemographics, health care factors, and known correlates of mammography screening, women living in more disadvantaged areas had lower odds of engaging in repeat mammography than women living in the most advantaged areas [OR comparing quartile 4 (most disadvantaged) to quartile 1 (most advantaged) = 0.63; 95% confidence interval, 0.50-0.80].
  
  
  CONCLUSIONS
  The results of this nationwide study support the hypothesis that area-level SEP is independently associated with mammography utilization.
  
  
  CONCLUSIONS
  These findings underscore the importance of addressing area-level social inequalities, if uptake of mammography screening guidelines is to be realized across all social strata.
authors.affiliation: Health Sciences Department, Gettysburg College, 300 N. Washington St., Campus Box 432, Gettysburg, PA 17325, USA. adailey@gettysburg.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Dailey
authors.forename: Babette A
authors.initials: BA
authors.lastname: Brumback
authors.forename: Melvin D
authors.initials: MD
authors.lastname: Livingston
authors.forename: Beth A
authors.initials: BA
authors.lastname: Jones
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Curbow
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Xu
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000191:economics* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000191:economics* / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance; D012959:Socioeconomic Factors