Race/ethnicity and the socioeconomic status gradient in women's cancer screening utilization: a case of diminishing returns?

Abstract

Using three years (2006, 2008, 2010) of nationally representative data from the Behavioral Risk Factor Surveillance System, I assessed the socioeconomic status (SES) gradient for odds of receiving a mammogram in the past two years and a Pap test in the past three years among White, Black, Hispanic, and Asian women living in the U.S. Mammogram and Pap test utilization were less likely among low-SES women. However, women of color experience less benefit than Whites from increasing SES for both screenings; as income and education increased, White women experienced more pronounced increases in the likelihood of being screened than did women of color. In what might be referred to as paradoxical returns, Asian women actually experienced a decline in the likelihood of obtaining a recent Pap test at higher levels of education. My findings suggest that women of color differ from Whites in the extent to which increasing socioeconomic resources is associated with increasing cancer screening utilization.

Figure 1

Percentages of women reporting recent mammogram and pap test by race/ethnicity. ***p < .001 significantly different from Whites; two- tailed test.

Figure 2

Predicted probabilities of mammogram use by race/ethnicity and household income.^{a a}All control variables held at means (Weighted Based on results from Model 3).

Figure 3

Predicted probabilities of pap test use by race/ethnicity and household income.^{a a}All control variables held at means (Based on results from Model 4).

Figure 4

Predicted probabilities of mammogram use by race/ethnicity and educational attainment.^{a a}All control variables held at means (Based on results from Model 5).

Figure 5

Predicted probabilities of pap test use by race/ethnicity and educational attainment.^{a a}All control variables held at means (Based on results from Model 6).