Quality of Chronic and Preventive Care by Cold-Spot Designation
| Cold-Spot Designation | ||||||
|---|---|---|---|---|---|---|
| Poverty | Low Education | Social Deprivation Index | ||||
| Percentage with the Chronic Condition or Receiving the Preventive Measure | ||||||
| Cold Spot | Noncold Spot | Cold Spot | Noncold Spot | Cold Spot | Noncold Spot | |
| Chronic conditions | ||||||
| Obesity | 34%* | 28% | 37%* | 28% | 35%* | 28% |
| Uncontrolled diabetes | 14% | 12% | 15%* | 13% | 15%* | 13% |
| Preventive measures | ||||||
| Prostate cancer | 45%* | 50% | 45%* | 50% | 47% | 49% |
| Pneumonia vaccination | 23% | 23% | 25%* | 23% | 23% | 23% |
| Colon cancer screening | 30%* | 32% | 29%* | 32% | 30%* | 32% |
| Cervical cancer screening | 16%* | 15% | 17%* | 15% | 17%* | 15% |
| Aspirin | 44% | 43% | 44% | 43% | 44% | 43% |
↵* Percentages are significantly different (P < .05).
Cold spots are defined as those census tracts in the highest quartiles for poverty, low education, and composite social deprivation. Poverty is measured by the percentage earning less than 200% of the federal poverty level. Low education measured by the percentage without a high school diploma or General Education Development. The Social Deprivation Index is a composite measure of community material and social deprivation and is a score from 0 to 100.
Obesity was defined as those with a body mass index of 30 kg/m2 or more.
Uncontrolled diabetes was defined as those with a hemoglobin A1c of 9 or more.
We assessed pneumonia vaccination by determining whether those 65 years or older had one dose of the 23- or 13-valent pneumococcal vaccine, colorectal cancer screening by determining whether those aged 50 to 75 years had a colonoscopy within the past 10 years or a fecal occult blood test within the past year, cervical cancer screening by determining whether those aged 21 to 65 years had a pap smear within the past 3 years or those aged 30 to 65 years had a pap smear and human papilloma virus testing within the past 5 years, prostate cancer screening by whether men aged 55 to 70 years had a prostate-specific antigen performed within the past 2 years (excluding those with personal or family histories of prostate cancer, and African Americans), and aspirin use by determining whether those with a diagnosis of heart disease, congestive heart failure, or peripheral vascular disease had aspirin prescribed.