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Martin C. Weinrich, PhD, Dept. of Bioinformatics and Biostatistics, University of Louisville, School of Public Health & Information Sciences, 555 S. Floyd Street, Room 4063, Louisville, KY 40202, 502 852-2038, mweinrich@mcg.edu, Carlton A. Hornung, PhD, Dept. of Epidemiology and Clinical Investigation Sciences, Univ of Louisville, School of Public Health & Information Sciences, 555 S Floyd St., Louisville, KY 40202, Charles J. Mundt, MA, Dept. of Epidemiology and Clinical Investigation Sciences, University of Louisville, School of Public Health and Information Sciences, 555 S. Floyd Street, Louisville, KY 40202, and William Paul McKinney, MD, Dept. of Health Knowledge and Cognitive Sciences, University of Louisville, School of Public Health and Information Sciences, 555 S Floyd St., Louisville, KY 40202.
The authors analyzed data from the Behavioral Risk Factor Surveillance Survey (BRFSS) to show that American males aged 50 years or more reported receiving only 46.0% of the preventive services recommended for them by the U.S. Task Force on Preventive Services. The comparable figure for females was 57.8%; that difference was statistically highly significant (p<0.001). These estimates and their standard errors were computed using SUDAAN (Research Triangle Institute), in order to take into account the effects of the sampling design upon the estimates and their standard errors. The observed patterns of demographic variation in percent compliance were consistent for each gender: white ethnicity, greater income, and higher educational level were each associated with greater percent compliance. Except for former smokers, who reported the highest percent compliance, non-smokers had the highest percent compliance, and compliance was inversely associated with smoking frequency. In all cases, females were more compliant than males. The list of recommended preventive services for women adds three preventive services (Pap smear, mammography, and breast examination by a health professional) to the five services that are recommended for men (blood pressure and cholesterol checking, fecal occult blood testing, and flu and pneumonia immunization for those aged 65 years or greater). The data were therefore reanalyzed to compare percent compliance among men versus women, but only for the set of five preventive services recommended for both genders. The same pattern of variation in rates according to ethnicity, income level, educational level, and smoking patterns persisted in the new analyses. But the gender differences virtually disappeared. Compliance rates were now 46.0% for males (as before) versus just 45.9% for females. The gender differences that were originally observed resulted entirely from women’s high rates of reported compliance with the three services specifically recommended for them. Several sets of analyses were carried out in order to examine trends in the observed patterns of compliance rates. Our results raise the possibility that educational and other programs to increase compliance rates for the remaining five services might both (1) further increase the compliance rate in females, and (2) reduce the gender difference in compliance.
Learning Objectives:
Keywords: Primary Prevention, Access and Services
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.