TY  - JOUR
AU  - Heintzman, John
AU  - Hatch, Brigit
AU  - Coronado, Gloria
AU  - Ezekiel, David
AU  - Cowburn, Stuart
AU  - Escamilla-Sanchez, Octavio
AU  - Marino, Miguel
PY  - 2018
TI  - Role of Race/Ethnicity, Language, and Insurance in Use of Cervical Cancer Prevention Services Among Low-Income Hispanic Women, 2009-2013
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E25
VL  - 15
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - INTRODUCTION  Hispanic women in the United States have an elevated risk of cervical cancer, but the existing literature does not reveal why this disparity persists. METHODS  We performed a retrospective cohort analysis of 17,828 low-income women aged 21 to 64 years seeking care at Oregon community health centers served by a hosted, linked electronic health record during 2009 through 2013. We assessed the odds of having had Papanicolaou (Pap) tests and receiving human papillomavirus (HPV) vaccine, by race/ethnicity, insurance status, and language. RESULTS  Hispanic women, regardless of pregnancy status or insurance, had greater odds of having had Pap tests than non-Hispanic white women during the study period. English-preferring Hispanic women had higher odds of having had Pap tests than Spanish-preferring Hispanic women (OR, 2.08; 95% confidence interval [CI], 1.63-2.66) but lower odds of having received HPV vaccination (OR, 0.21; 95% CI, 0.12-0.38). Uninsured patients, regardless of race/ethnicity, had lower odds of HPV vaccine initiation than insured patients did. Once a single dose was received, there were no significant racial/ethnic differences in vaccine series completion. CONCLUSION  In this sample of low-income women seeking care at Oregon community health centers, we found minimal racial/ethnic disparities in the receipt of cervical cancer prevention services. Inequities by insurance status, especially in the receipt of HPV vaccine, persist. Community health center-based care may be a useful model to address racial/ethnic disparities in prevention, but this model would need further population-wide study.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd15.170267
DO  - 10.5888/pcd15.170267
ER  - 
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