Table 3.

Quality of Chronic and Preventive Care by Cold-Spot Designation

Cold-Spot Designation
PovertyLow EducationSocial Deprivation Index
Percentage with the Chronic Condition or Receiving the Preventive Measure
Cold SpotNoncold SpotCold SpotNoncold SpotCold SpotNoncold Spot
Chronic conditions
    Uncontrolled diabetes14%12%15%*13%15%*13%
Preventive measures
    Prostate cancer45%*50%45%*50%47%49%
    Pneumonia vaccination23%23%25%*23%23%23%
    Colon cancer screening30%*32%29%*32%30%*32%
    Cervical cancer screening16%*15%17%*15%17%*15%
  • * 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.