Document Type
Article
Publication Date
2025
Advisor
Jeannette Manger
Abstract
Introduction: Despite Medicare fully covering annual mammogram costs, less than one half of female Ohio residents aged 65-74 sought yearly mammograms. As such, our analyses explore which social and structural determinants of health predict the likelihood that a woman aged 65-74 on Medicare will receive an annual mammogram.
Methods: This retrospective analysis utilized data from the County Health Rankings database, focusing on female Medicare enrollees aged 65-74. Mammography screening rates were compared across counties within Ohio, Michigan, and Missouri. Pearson and Spearman correlation tests were employed to examine relationships between English non-proficiency, high school graduation rates, residential segregation, primary care access, and mammography screening rates. ANOVA tests were conducted to compare screening rates and median household income across Ohio, Michigan, and Missouri. Stepwise multiple linear regression was used to identify predictors of annual mammography rates in Ohio.
Results: Significant correlations were found between mammography screening rates and English proficiency (r = 0.39, p < 0.001), high school graduation rates (r = 0.51, p = 0.001), and primary care physician availability (r = 0.38, p < 0.001). No significant correlation was observed between residential segregation and screening rates (r = -0.06, p = 0.62). Significant differences exist in mammography screening rates across Ohio, Michigan, and Missouri, with Michigan having the highest rate. A weak but significant correlation was found between median household income and screening rates (r = 0.37, p < 0.001). No significant difference in mammography rates exists between Ohio counties with high and low average age (t = -0.591, p = 0.273). High school graduation rate and limited English non-proficiency were the only significant predictors of mammography screening rates.
Conclusion: Social determinants of health including education, English proficiency, and access to care, significantly influence mammography screening rates among Medicare beneficiaries. Addressing disparities in education, language access, and healthcare availability may help reduce the gap in breast cancer screening rates. Further research is needed to explore the role of health literacy and geographic access in improving screening rates.
Repository Citation
Fuglsang, S., & Khatri, R. (2025). Social and Structural Determinants of Mammography Screening Rates Among Female Medicare Beneficiaries: A Retrospective Analysis. Wright State University. Dayton, Ohio.
