Associations between Insurance Status, Financial Hardship, and Rurality on Receipt of Guideline-Concordant Mammography
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Varying mammography guidelines can serve as a barrier to care. It is unknown how financial hardship, insurance, and rurality are associated with mammography receipt. METHODS: This cross-sectional study used 2023 National Health Interview Survey data. Outcomes included receipt of an American Cancer Society (ACS) or US Preventive Services Task Force (USPSTF) guideline-concordant mammogram. Exposures included report of healthcare-related financial hardship (HRFH), insurance status, and rurality. We estimated ORs and 95% confidence intervals (CI) to assess the interaction between (1) HRFH and insurance status and (2) HRFH and rurality on receipt of an ACS or USPSTF mammogram. RESULTS: A total of 11,138 women were included who were eligible to receive a mammogram based on USPSTF guidelines. The mean age was 51 years, 61% were non-Hispanic White, 10% lived in poverty, and 19% had not received a USPSTF guideline-concordant mammogram. We found that among insured individuals, those who did vs did not report HRFH had lower odds of receipt of a USPSTF guideline-concordant mammogram (OR, 0.68; 95% CI, 0.58-0.80). Additionally, we found that among urban residents, those who did vs did not report HRFH had lower odds of receipt of an USPSTF guideline-concordant mammogram (OR, 0.68; 95% CI, 0.58-0.79). The results were similar assessing the receipt of an ACS guideline-concordant mammogram. CONCLUSIONS: Financial hardship is a barrier to mammography regardless of insurance status and rural residence. IMPACT: Programs that address financial barriers to cancer screening beyond insurance and rural access are needed.
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4414593148