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Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders

BACKGROUND: Despite recommendations for cancer screening for breast and colorectal cancer among the Medicare population, preventive screenings rates are often lower among vulnerable populations such as the small but rapidly growing older American Indian and Alaska Native (AIAN) population. This stud...

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Autores principales: Towne, Samuel D, Smith, Matthew Lee, Ory, Marcia G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077226/
https://www.ncbi.nlm.nih.gov/pubmed/24913150
http://dx.doi.org/10.1186/1476-072X-13-18
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author Towne, Samuel D
Smith, Matthew Lee
Ory, Marcia G
author_facet Towne, Samuel D
Smith, Matthew Lee
Ory, Marcia G
author_sort Towne, Samuel D
collection PubMed
description BACKGROUND: Despite recommendations for cancer screening for breast and colorectal cancer among the Medicare population, preventive screenings rates are often lower among vulnerable populations such as the small but rapidly growing older American Indian and Alaska Native (AIAN) population. This study seeks to identify potential disparities in the availability of screening services, distance to care, and the utilization of cancer screening services for Medicare beneficiaries residing in areas with a higher concentration of AIAN populations. METHODS: Using the county (n =3,225) as the level of analysis, we conducted a cross-sectional analysis of RTI International’s Spatial Impact Factor Data (2012) to determine the level of disparities for AIAN individuals. The outcomes of interest include: the presence of health care facilities in the county, the average distance in miles to the closest provider of mammography and colonoscopy (analyzed separately) and utilization of screening services (percent of adults aged 65 and older screened by county). RESULTS: Counties with higher concentrations of AIAN individuals had greater disparities in access and utilization of cancer screening services. Even after adjusting for income, education, state of residence, population 65 and older and rurality, areas with higher levels of AIAN individuals were more likely to see disparities with regard to health care services related to mammograms (p ≤ .05; longer distance, lower screening) and colonoscopies (p ≤ .05; longer distance, lower screening). CONCLUSIONS: These findings provide evidence of a gap in service availability, utilization and access facing areas with higher levels of AIAN individuals throughout the US. Without adequate resources in place, these areas will continue to have less access to services and poorer health which will be accelerated as the population of older adults grows.
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spelling pubmed-40772262014-07-02 Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders Towne, Samuel D Smith, Matthew Lee Ory, Marcia G Int J Health Geogr Research BACKGROUND: Despite recommendations for cancer screening for breast and colorectal cancer among the Medicare population, preventive screenings rates are often lower among vulnerable populations such as the small but rapidly growing older American Indian and Alaska Native (AIAN) population. This study seeks to identify potential disparities in the availability of screening services, distance to care, and the utilization of cancer screening services for Medicare beneficiaries residing in areas with a higher concentration of AIAN populations. METHODS: Using the county (n =3,225) as the level of analysis, we conducted a cross-sectional analysis of RTI International’s Spatial Impact Factor Data (2012) to determine the level of disparities for AIAN individuals. The outcomes of interest include: the presence of health care facilities in the county, the average distance in miles to the closest provider of mammography and colonoscopy (analyzed separately) and utilization of screening services (percent of adults aged 65 and older screened by county). RESULTS: Counties with higher concentrations of AIAN individuals had greater disparities in access and utilization of cancer screening services. Even after adjusting for income, education, state of residence, population 65 and older and rurality, areas with higher levels of AIAN individuals were more likely to see disparities with regard to health care services related to mammograms (p ≤ .05; longer distance, lower screening) and colonoscopies (p ≤ .05; longer distance, lower screening). CONCLUSIONS: These findings provide evidence of a gap in service availability, utilization and access facing areas with higher levels of AIAN individuals throughout the US. Without adequate resources in place, these areas will continue to have less access to services and poorer health which will be accelerated as the population of older adults grows. BioMed Central 2014-06-09 /pmc/articles/PMC4077226/ /pubmed/24913150 http://dx.doi.org/10.1186/1476-072X-13-18 Text en Copyright © 2014 Towne et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Towne, Samuel D
Smith, Matthew Lee
Ory, Marcia G
Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title_full Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title_fullStr Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title_full_unstemmed Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title_short Geographic variations in access and utilization of cancer screening services: examining disparities among American Indian and Alaska Native Elders
title_sort geographic variations in access and utilization of cancer screening services: examining disparities among american indian and alaska native elders
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4077226/
https://www.ncbi.nlm.nih.gov/pubmed/24913150
http://dx.doi.org/10.1186/1476-072X-13-18
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