• Preventive medicine · Aug 2012

    Using colorectal trends in the U.S. to identify unmet primary care needs of vulnerable populations.

    • Patricia Y Miranda, Michelle Johnson-Jennings, Wassim Tarraf, Patricia González, William A Vega, and Hector M González.
    • The Pennsylvania State University, Department of Health Policy and Administration, USA.
    • Prev Med. 2012 Aug 1; 55 (2): 131136131-6.

    BackgroundColorectal cancer screening (CRC) disparities have worsened in recent years.ObjectiveTo examine progress toward Healthy People 2010 goals for CRC screening among ethnic/racial groups, including disaggregated Latino groups.MethodsMultivariate logistic regressions examined associations between ethnicity/race and primary outcomes of self-reported guideline-concordant CRC screenings considering time trends for 65,947 respondents of the Medical Expenditure Panel Survey from 2000 to 2007 age 50-years and older from six groups (non-Latino White, non-Latino Black, Puerto Rican, Cuban, Mexican, and Other Latino). We also tested for modification effects by education, income, and health insurance.ResultsMost groups approached Healthy People 2010 CRC screening rate goals, including non-Latino Whites (47%), non-Latino Blacks (42%) and Puerto Ricans (40%), while Mexicans remained disparately lower (28%). Higher education, income and insurance coverage, partially attenuated this lower likelihood, but Mexican rates remained significantly lower than non-Latino Whites for receiving endoscopy in the past 5 years {OR(95% CI)=0.68(0.59-0.77)} and having received any CRC screening {0.70(0.62-0.79)}.ConclusionsAmong ethnic/racial groups examined, only Mexicans met healthcare disparity criteria in CRC screening. Findings suggest that healthcare equity goals can be attained if resources affecting continuity of care or ability to pay for preventive services are available, and targeted populations are adequately identified.Copyright © 2012 Elsevier Inc. All rights reserved.

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