Breast cancer is the second major cause of cancer-related death of women in the United States 1, yet current gaps exist in breast cancer screening for minority women 2. The purpose of this study is to address these gaps by assessing the relationships among race, health insurance coverage, and breast cancer screening in a nationally representative sample of women.
A cross-sectional descriptive analysis of the 2018 BRFSS survey data was used to meet the study purpose. BRFSS participants who declared themselves to be of female sex and who were adults with the age ≥ of 40 years were selected for inclusion.
Data were analyzed using SPSS version 26. Exploratory and descriptive analyses were performed, followed by comparative analyses based on the variable type. Relationships between race, insurance status, and mammogram screening were examined. Chi-square, logistic, and multinomial logistic regression were used.
The original 2018 BRFSS dataset included 437,436 participants and 145,837 women were selected based on inclusion criteria. Participant age ranged from 40 to 74 years. The majority were White only non-Hispanic (78.1%), reported having a mammogram in the past two years (76.1%), had earned < a 4-year college degree (61.1%), had an annual income of < $75,000 (58.4%) and married (58.2%). Less than half had a healthcare plan through an employer (44.9%) and were employed (40.5%). Participants who had a plan purchased through an employer or union were more likely to have a mammogram in the past two years when compared with other health coverage. Furthermore, White only, non-Hispanics were 1.25 times more likely and Black only, non-Hispanics were 1.98 times more likely to have a mammogram in the past two years compared to participants from other racial and ethnic groups.
The findings of this study provide an additional indication that race, and health insurance status do impact breast cancer screening.
Knowledge gained from this study can be used by practicing nurses to educate racial and ethnic minority women on the significance of breast cancer screening and prevention.