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APHA Scientific Session and Event Listing

Mythreyi Bhargavan, PhD and Jonathan Sunshine, PhD. Research, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191, 703-648-8983, mbhargavan@acr.org

Rationale: Among women age 40 and older, minority women have been found to have mammograms at a lower rate than white women. One potential cause may be that minority women live in neighborhoods with no mammography facilities in proximity to them, or because facilities in their neighborhoods are inadequately committed to patient service.

Objective: The objective of this study is to measure if high percentage of minority population influences facility location decisions, in terms of two sets of outcomes: (a) whether mammography facilities locate in or near the zip-code, and (b) commitment to patient service of mammography facilities in it.

Data and Methods: Target zip-codes are categorized as high-white or high-minority based on the race and ethnicity of the largest sub-population in the zip-code. Quantitative outcomes of interest are (i) presence of a mammography facility, (ii) the number of facilities per 100,000 women age 40 and older. The explanatory variables are socio-economic characteristics of the target and surrounding zip-codes. Outcomes will be estimated using logistic and linear regressions. In addition, logistic regression is used to compare mammography facilities in high-minority and high-white zip-codes along qualitative characteristics, such as whether the facility accepts Medicaid and charity patients, language skills and minority composition of front office staff, types of outreach activities, etc. Data on demographic and socio-economic characteristics of zip-codes are obtained from the US Census. The list of mammography facilities and their zip-codes is obtained from the American College of Radiology (ACR) and Food and Drug Administration (FDA) databases. Patient-service commitment was measured using a pilot phone survey of mammography facilities.

Principal findings: Controlling for zip-code socio-economics and population density, high black and Hispanic zip-codes are much less likely to have a mammography facility in them than predominantly white zip-codes (for example, 10% increase in the black percentage of the population decreases the odds of a facility in the zip-code by 14%). Facilities in high minority zip-codes seem to be more committed to patient service than those in high-white areas, for example, one-half of the facilities surveyed in high-Hispanic and three-fifths of those in high-black zip-codes use posters and flyers for outreach into the community to educate women about mammograms, whereas less than one-third of the facilities in the high-white zip-codes do.

Conclusions: High-minority zip-codes are less likely to have mammography facilities, but facilities in high-minority zip-codes may be more committed to patient care than those in high-white zip-codes.

Learning Objectives: