Disability and receipt of clinical preventive services among women

Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey 08854, USA.
Women s Health Issues (Impact Factor: 2.33). 11/2006; 16(6):286-96. DOI: 10.1016/j.whi.2006.09.002
Source: PubMed


More individuals are surviving catastrophic injuries and living longer with persistent disability; however, their receipt of clinical preventive services is not well understood as compared with those without disabilities given the dual focus of care on both primary prevention and the prevention of secondary complications related to their disabilities.
Longitudinal analyses of 1999-2002 Medical Expenditure Survey (MEPS). Study sample consisted of 3,183 community-dwelling women aged 51-64 years and followed for 2 full years. Women with disabilities were defined as having reported any limitation in any area of activity of daily living in 2 years. Recommended clinical preventive services were defined as receiving the following at the recommended intervals: colorectal, cervical, and breast cancer; cholesterol screening; and influenza immunization. chi(2) tests and multiple logistic regressions were used to examine variations in use of clinical preventive services.
Overall, 23% of the women in the study (n = 835) were disabled. Disabled women, however, were less likely to receive mammography and Pap smears within the recommended intervals. However, disabled women were more likely to receive influenza immunization, cholesterol screening, and colorectal screening within the recommended intervals. Among the disabled, usual source of care and health insurance remained significant predictors of receipt of clinical preventive services across all types,
Disabled women were less likely to receive some of the cancer screening services, suggesting a need for targeted interventions to promote breast cancer and cervical cancer screening. Increased access to health care insurance and health care providers may also help.

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    • "Since the 1970s the life expectancy rates of women with disability has shifted significantly (Sheets 2010). Women with disability today live longer than women with disability in the past (Magoon and Meadows-Oliver 2011; Wei, Findley, and Sambamoorthi 2006), particularly with the advances in medical treatment, technology and practice (Magoon and Meadows-Oliver 2011). While identifying the specific life expectancy (in years) for someone with a limitations were more likely to not be in the workforce, affecting income, than women without such limitations. "
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    ABSTRACT: This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and papers not meeting the eligibility criteria, 25 papers were systematically and critically reviewed. Socio-demographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, healthcare workers and physical barriers. Socio-demographic, health insurance, health workers and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in healthcare, rather than being marginalized because of their disability.
    No preview · Article · Sep 2015 · Women & Health
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    • "A great proportion of aboriginal people reside in rural areas, and the medical vehicles that provide Pap smear tests regularly visit these areas to offer health care services, thereby improving the Pap smear test usage rate among aboriginal women. The Pap smear test usage rate of the married population was substantially greater than that of the unmarried population, which is consistent with the findings reported in previous studies [6,22,27]. This phenomenon may be because of the common misconception held by the public and physicians that unmarried people do not or seldom engage in sexual activity and, thus, are less susceptible to cervical cancer. "
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    ABSTRACT: Background This study examines the Pap smear usage conditions and relevant influential factors for 18,204 women aged 30 years and above with intellectual disabilities, using nationwide data from 2008. Methods The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of Pap smear testing by women with intellectual disabilities. Chi-square test was used to assess the correlation between Pap smear test usage and several variables. Logistic regression analysis was employed to explore the factors that influence Pap smear test usage. Results The results show that 4.83% (n =880) of women with intellectual disabilities underwent Pap smear tests. Pap smear test usage rates exhibit a declining trend with increases in age. Factors that significantly influence Pap smear test use include age, urbanization level of resident area, monthly salary, aboriginal status, marital status, existence of DM, severity of disability. Conclusions The women with intellectual disabilities had a low use rate of Pap smear test, which is significantly less than the 28.8% usage rate for the general population of women aged 30 years and above.
    Full-text · Article · Jun 2014 · BMC Health Services Research
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    • "Future research is needed to assess the extent to which implementation of obesity screening affects weight management counseling across groups. For cancer screening (i.e., lower GI endoscopy screening for colorectal cancer, mammography, and Pap tests), our results contrast with a number of prior studies conducted in non-VA users [9,11,1314 . Unlike immunizations , mammography and lower GI endoscopies require an additional appointment; thus, it is unlikely that the similar receipt that was apparent for Veterans with a disability is solely a function of more visits. "
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    ABSTRACT: Veterans with disabilities are at an increased risk of secondary impairments and may have difficulty accessing preventive services; accessibility may differ between Veterans who do and do not receive care at Department of Veterans Affairs (VA) facilities. We used data from the 2003 and 2004 Behavioral Risk Factor Surveillance System surveys to evaluate associations between disability and receipt of preventive services in Veterans. Veterans with a disability were more likely to have received influenza vaccinations (VA users and nonusers), pneumococcal vaccinations (VA nonusers: p < 0.001; VA users: p = 0.073), weight management counseling (VA nonusers: p < 0.001; male VA users: p < 0.001), lower gastrointestinal (GI) endoscopy (VA nonusers: 50-64 yr, p = 0.03; VA users: ≥65 yr, p = 0.085), mammography (VA users: p = 0.097), and serum cholesterol screening (VA nonusers: p < 0.001). Receipt was similar by disability status for fecal occult blood test (FOBT), lower GI endoscopy (VA users: 50-64 yr), human immunodeficiency virus testing, and cervical cancer screening. For no measure was there significantly lower receipt in those with versus without a disability, although there was marginal evidence in VA nonusers for overall colorectal cancer screening (i.e., lower GI endoscopy or FOBT: p = 0.063). Among Veterans, having a disability did not appear to be a barrier to receiving appropriate preventive care.
    Full-text · Article · May 2012 · The Journal of Rehabilitation Research and Development
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