 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Shin-Ping Tu, MD, MPH1, Sara Jackson, MD, MPH2, Yutaka Yasui, PhD3, Michèle Deschamps, PhD4, T. G. Hislop, MDCM5, and Victoria M. Taylor, MD, MPH3. (1) Division of General Internal Medicine, Harborview Medical Center, Box 359780, 325 Ninth Avenue, Seattle, WA 98104, (2) Department of Medicine, University of Washington, 1825 N. 52nd St., Seattle, WA 98103, (206) 547-7223, sljack@u.washington.edu, (3) Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, PO Box 19024, MP702, 1100 Fairview Avenue N., Seattle, WA 98109-1024, (4) Direction de santé publique Montréal-Centre, 1301 rue Sherbrooke, est, Montréal, QC H2L 1M3, Canada, (5) Cancer Control Research, BC Cancer Agency, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada
BACKGROUND: The objective of this analysis was to compare PAP testing and screening mammography among Chinese women in two distinct health delivery systems; a combination of public, private and no insurance in Seattle, WA and a universal health care system in Vancouver, BC. METHODS: Using community-based sampling methods, Chinese women in Seattle and Vancouver were interviewed by trilingual female interviewers in 1999. Women were queried about multiple preventive health behaviors, demographic data and health care access. The PAP testing analysis included 1056 women aged 20-69 yrs, and the mammography analysis included 409 women aged 50-74 yrs. RESULTS: Chinese women in Vancouver (compared to Seattle) were younger, more educated, more fluent in English, with 87% having a Chinese provider (compared to 25% in Seattle). No statistically significant differences were observed between the two cities for screening mammography in the last two years. PAP testing was higher in Seattle compared to Vancouver (66% vs 60% respectively; p=0.05). The city effect (Seattle compared to Vancouver) was independently predictive of higher PAP testing in multiple logistic regression models when no adjustment was made (OR 1.29, 95% CI (1.00, 1.66)) and when adjusted for only demographic variables (OR 1.58, 95% CI (1.16, 2.15)): the city effect was of similar magnitude but became statistically less significant when adjusted for all demographic and access variables (OR 1.43, 95% CI (0.93, 2.22)). CONCLUSION: Despite universal health care coverage and baseline characteristics typically associated with greater utilization of preventive screening services, our results indicate that for Chinese women, universal health coverage did not improve screening rates for mammography or PAP tests.
Learning Objectives:
Keywords: Access to Health Care, Asian Women
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.