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Race and Ethnic Disparities in Cervical Cancer Screening in a Safety-Net System

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Objectives: The three objectives of this research were: 1) to examine the use of Pap smear tests among low-income women, including minority and immigrant women who were patients in a safety-net healthcare system; 2) to identify policy relevant variables that could lead to changes in use of Pap smear screening services for these women; and 3) to contribute to the literature on use of Pap smear screening, especially among minorities and immigrants. The Behavioral Model for Vulnerable Populations was used as the theoretical framework. Methods: Pap smear screening predictors were examined using telephone interviews with a random sample of women aged 18–60, including 465 Non-Hispanic Whites, 285 African Americans, 164 Hispanic Americans, and 256 Hispanic immigrants, enrolled in a safety-net healthcare system in Texas in Fall 2000. Binary logistic regression analysis was used. Results: The research revealed that Non-Hispanic Whites were most likely to have been screened ever and in the past 3 years, followed by African Americans, Hispanic immigrants, and Hispanic Americans. Among Hispanics, immigrants were most likely to have had Pap smear screening, supporting the “healthy immigrant hypothesis.” Older women were most likely to have ever been screened, with younger women, most likely in the past year. Having a usual source of healthcare and a checkup for current pregnancy increased screening, while competing needs (food, clothing, housing) affected screening negatively. Conclusions: Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.

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ACKNOWLEDGMENTS

This research was funded by a grant from the Texas Higher Education Coordinating Board, Advanced Research Program, Social and Behavioral Sciences, 2000–2002, #003594-0120-1999.

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Authors and Affiliations

  1. Department of Sociology, University of North Texas, Denton, Texas, 76203, USA

    Gertrude A. Owusu PhD, MPH & Cynthia M. Cready PhD

  2. Department of Applied Gerontology, University Honors Program, University of North Texas, Denton, Texas, 76203, USA

    Susan Brown Eve PhD

  3. Department of Economics, University of North Texas, Denton, Texas, 76203, USA

    Kenneth Koelln PhD

  4. School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, 76107, USA

    Fernando Trevino PhD & Ximena Urrutia-Rojas DrPH

  5. Department of Family and Community Medicine, John Peter Smith Hospital, Forth Worth, Texas, 76104, USA

    Joanne Baumer MD

  6. University of Texas Southwestern Medical Center, Texas, USA

    Joanne Baumer MD

  7. Department of Applied Gerontology, University Honors Program, University of North Texas, P.O. Box 305189, Denton, Texas, 76203-5189, USA

    Susan Brown Eve PhD

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  1. Gertrude A. Owusu PhD, MPH
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Correspondence to Susan Brown Eve PhD.

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Owusu, G.A., Eve, S.B., Cready, C.M. et al. Race and Ethnic Disparities in Cervical Cancer Screening in a Safety-Net System. Matern Child Health J 9, 285–295 (2005). https://doi.org/10.1007/s10995-005-0004-8

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  • DOI: https://doi.org/10.1007/s10995-005-0004-8

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