The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: who gets the message about breast cancer screening?

Am J Public Health. 2001 Jan;91(1):49-54. doi: 10.2105/ajph.91.1.49.


Objectives: This study investigated the association between physician recommendation for mammography and race/ethnicity, socioeconomic status, and other characteristics in a rural population.

Methods: In 1993 through 1994, we surveyed 1933 Black women and White women 52 years and older in 10 rural counties.

Results: Fifty-three percent of the women reported a physician recommendation in the past year. White women reported recommendations significantly more often than did Black women (55% vs 45%; odds ratio = 1.49). Controlling for educational attainment and income eliminated the apparent racial/ethnic difference. After control for 5 personal, 4 health, and 3 access characteristics, recommendation for mammography was found to be more frequent among women who had access to the health care system (i.e., had a regular physician and health insurance). Recommendation was less frequent among women who were vulnerable (i.e., were older, had lower educational attainment, had lower annual family income).

Conclusions: Socioeconomic status, age, and other characteristics--but not race/ethnicity--were related to reports of a physician recommendation, a precursor strongly associated with mammography use. Efforts to increase physician recommendation should include complementary efforts to help women address socioeconomic and other barriers to mammography use.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Black or African American / statistics & numerical data*
  • Cohort Studies
  • Female
  • Health Services Accessibility
  • Health Status
  • Humans
  • Logistic Models
  • Mammography / statistics & numerical data*
  • Middle Aged
  • North Carolina / epidemiology
  • Odds Ratio
  • Practice Patterns, Physicians'*
  • Referral and Consultation*
  • Rural Health Services
  • Socioeconomic Factors
  • White People / statistics & numerical data*