Correlates of mammography among women with low and high socioeconomic resources

Prev Med. 1995 Mar;24(2):149-58. doi: 10.1006/pmed.1995.1028.


Background: Although screening mammography rates have increased, even women with higher incomes and more formal education do not all obtain the exam. This study examined why a modest proportion of higher income/higher education women do not get screened and, conversely, why a small percentage of lower income/lower education women do receive screening.

Methods: Data were from the 1990 National Health Interview Survey of Health Promotion and Disease Prevention. A total of 3,014 women, ages 40-75, were in the sample. Low-resource women had incomes of less than $20,000 and less than a high school diploma. High-resource women had incomes of $30,000 or more and at least some college education.

Results: Correlates of screening status were similar for both resource groups. Recency of Papanicolaou test, recency of clinical breast exam, and regular breast self-examination were associated with higher rates of screening. Four or more persons in a household were associated with lower rates. Among low-resource women, incomes of $10,000-$19,999 were associated with higher likelihood of screening. An income of $50,000 or more was associated with screening among high-resource women.

Conclusions: The fact that several variables were important for both resource groups suggests that targeted interventions could have benefits across a wide population. Nonetheless, in the high-resource group, 2-year rates never exceeded 80% and repeated screening never exceeded 60%. Rates for low-resource women were over 30% lower. Medical care utilization data did not differ between the two resource groups sufficiently to account for the discrepant rates. Improving screening rates in both resource groups remains a major challenge.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Appointments and Schedules
  • Cohort Studies
  • Female
  • Health Behavior*
  • Health Services Accessibility
  • Humans
  • Logistic Models
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Odds Ratio
  • Papanicolaou Test
  • Salaries and Fringe Benefits*
  • Socioeconomic Factors
  • United States
  • Vaginal Smears / statistics & numerical data