title: Disparities in vaccinations and cancer screening among U.S.- and foreign-born Arab and European American non-Hispanic White women.
abstract: BACKGROUND
  Disparities in vaccinations and cancer screening exist when comparing foreign-born and U.S.-born women collectively and disaggregated by race and ethnicity. The purpose of this study was to estimate and compare the age-adjusted prevalence of not receiving a flu or pneumonia vaccine, clinical breast examination, mammogram or Pap smear among U.S.- and foreign-born White women by region of birth and examine associations while controlling for potential confounders.
  
  
  METHODS
  We pooled 12 years of National Health Interview Survey data (n = 117,893). To approximate an "Arab-American" ethnicity, we identified 15 "Arab" countries from the Middle East region that comprise the Arab Nations. Data was requested from the National Center for Health Statistics Research Data Center. We used the χ(2) statistic to compare descriptive statistics and odds ratios (ORs) with 95% CIs were used for inferential statistics.
  
  
  RESULTS
  Compared to U.S.-born, foreign-born Whites from the Arab Nations had higher estimates of not receiving recommended vaccinations and cancer screenings. In crude and adjusted analyses, foreign-born Arab-American women were less likely to report receiving a flu vaccine (OR, 0.34; 95% CI, 0.21-0.58), pneumonia vaccine (OR, 0.14; 95% CI, 0.06-0.32), Pap smear (OR, 0.13; 95% CI, 0.05-0.31), or clinical breast examination (OR, 0.16; 95% CI, 0.07-0.37) compared with U.S.-born White women. There were no differences for mammography.
  
  
  CONCLUSIONS
  This national study examining uptake of flu and pneumonia vaccines and preventive cancer screenings suggests that estimates are lower for foreign-born Arab-American women compared with U.S.-born White women. Future studies should collect qualitative data that assess the cultural context surrounding prevention and screening behaviors among Arab-American women.
authors.affiliation: Wellness, Health Promotion and Injury Prevention, School of Health Sciences, Oakland University, Rochester, Michigan. Electronic address: dallo@oakland.edu.
authors.forename: Florence J
authors.initials: FJ
authors.lastname: Dallo
authors.affiliation: Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Tiffany B
authors.initials: TB
authors.lastname: Kindratt
mesh_terms: D000328:Adult; D000368:Aged; D018912:Arabs / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004641:Emigration and Immigration; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*