Use of preventive care by the working poor in the United States

Prev Med. 2007 Mar;44(3):254-9. doi: 10.1016/j.ypmed.2006.11.006. Epub 2006 Dec 29.

Abstract

Objective: Examine the association between poverty and preventive care use among older working adults.

Method: Cross-sectional analysis of the pooled 1996, 1998 and 2000 waves of the Health and Retirement Study, a nationally representative sample of older community-dwelling adults, studying self-reported use of cervical, breast, and prostate cancer screening, as well as serum cholesterol screening and influenza vaccination. Adults with incomes within 200% of the federal poverty level were defined as poor.

Results: Among 10,088 older working adults, overall preventive care use ranged from 38% (influenza vaccination) to 76% (breast cancer screening). In unadjusted analyses, the working poor were significantly less likely to receive preventive care. After adjustment for insurance coverage, education, and other socio-demographic characteristics, the working poor remained significantly less likely to receive breast cancer (RR 0.92, 95% CI, 0.86-0.96), prostate cancer (RR 0.89, 95% CI, 0.81-0.97), and cholesterol screening (RR 0.91, 95% CI, 0.86-0.96) than the working non-poor, but were not significantly less likely to receive cervical cancer screening (RR 0.96, 95% CI, 0.90-1.01) or influenza vaccination (RR 0.92, 95% CI, 0.84-1.01).

Conclusion: The older working poor are at modestly increased risk for not receiving preventive care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost of Illness
  • Cross-Sectional Studies
  • Employment* / economics
  • Employment* / psychology
  • Employment* / statistics & numerical data
  • Female
  • Health Promotion
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand
  • Humans
  • Male
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Poverty* / economics
  • Poverty* / psychology
  • Poverty* / statistics & numerical data
  • Preventive Health Services / economics
  • Preventive Health Services / statistics & numerical data*
  • Risk Assessment
  • Socioeconomic Factors
  • United States
  • Vulnerable Populations* / psychology
  • Vulnerable Populations* / statistics & numerical data