Association of Material Deprivation Status, Access to Health Care Services, and Lifestyle With Screening and Prevention of Disease, Montreal, Canada, 2012.
BACKGROUND
The objective of this study was to provide information on the effect of disparities in material deprivation, access to health care services, and lifestyle on the likelihood of undergoing screening for disease prevention.


METHODS
We used data from a probability sample (N = 10,726) of the Montreal population aged 15 years or older and assessed 6 dependent variables (screening for breast cancer, cervical cancer, colon cancer, blood glucose, and high blood pressure and receipt of the seasonal influenza vaccination), and 3 independent variables (disparities in material deprivation, access to health care services, and personal lifestyle habits). We used logistic regression to analyze data and determine associations.


RESULTS
Use of preventive health services increased as material deprivation declined, access to health care improved, and lifestyle habits became healthier. The combined effect of household income, an individual measure, and the material deprivation index (consisting of quintiles representing a range from the most privileged [quintile 1: best education, employment, and income] to the most deprived [quintile 5: least education, employment, and income) an ecological measure, showed that having a Papanicolaou test was significantly associated with high annual household income (≥$40,000) even if the woman resided in a deprived neighborhood (quintiles 4 and 5 of the material deprivation index) (odds ratio [OR], 1.38; 95% confidence interval (95% [CI], 1.04-1.84), whereas odds of having a mammogram or influenza vaccination were significantly associated with living in a privileged neighborhood (quintiles 1, 2, and 3 of the material deprivation index) even among people with a low annual household income (<$40,000) (mammogram: OR, 1.54; 95% CI, 1.00-2.38; influenza vaccination: OR, 1.31; 95% CI, 1.04-1.66).


CONCLUSIONS
In addition to influencing lifestyle habits and access to health care services, disparities in material deprivation influence whether a person uses preventive health services. Public health professionals need to establish screening outreach programs in socioeconomically disadvantaged neighborhoods to enhance public participation in disease prevention programs and reduce disparities in health.
Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, 1301 rue Sherbrooke Est, Montréal, Québec, H2L 1M. E-mail: gmeshefe@santepub-mtl.qc.ca.
Garbis A
GA
Meshefedjian
Direction régionale de santé publique, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal.
Marie-Jo
MJ
Ouimet
Direction régionale de santé publique, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal.
Louis-Robert
LR
Frigault
Direction régionale de santé publique, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal.
Viviane
V
Leaune
Direction régionale de santé publique, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal.
Sadoune
S
Ait Kaci Azzou
Direction régionale de santé publique, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal.
Marie-Ève
MÈ
Simoneau
Int J Prev Med. 2014 Dec;5(12):1616-20
25709799
Health Policy. 2013 Dec;113(3):247-57
24409498
Vaccine. 2009 Jun 19;27(30):3935-44
19467744
Oncol Nurs Forum. 2002 Oct;29(9):E91-8
12370705
Womens Health Issues. 2002 May-Jun;12(3):122-8
12015184
Diabetes Care. 1994 Oct;17(10):1158-63
7821136
Br J Gen Pract. 1998 Aug;48(433):1509-14
10024713
MMWR Morb Mortal Wkly Rep. 2015 May 8;64(17):464-8
25950253
JAMA. 2016 Apr 26;315(16):1750-66
27063997
Arch Intern Med. 1992 Jan;152(1):106-10
1728905
BMC Health Serv Res. 2006 Sep 13;6:116
16970813
Can J Public Health. 2013 Jun 21;104(4):e284-90
24044467
Chronic Dis Can. 2009;29(4):178-91
19804682
Rev Epidemiol Sante Publique. 2013 Oct;61(5):437-45
24012357
J Natl Cancer Inst. 1997 Oct 1;89(19):1406-22
9326910