THE HEALTH OF MINORITY WOMEN

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2. MINORITY WOMEN'S USE OF PREVENTIVE HEALTH SERVICES: VACCINATIONS AND SCREENINGS

These systemic, economic, social, and cultural barriers reduce the use of health care services by minority women. Women of every racial/ethnic group, including White women, have low immunization rates for pneumonia and influenza. Women of color often do not get preventive health tests such as screening for cervical cancer (Pap tests), mammograms, or blood pressure screenings. Moreover, the likelihood that minority women will get these preventive tests declines with their age. For all women, being married and having at least a high school education are associated with higher screening rates16.

A. Pneumococcal and Influenza Vaccinations

The U.S. Preventative Task Force recommends a single-dose pneumococcal vaccine for all adults 65 years of age and over. The vaccine provides protection against the adverse consequences of pneumonia17. In 2000, only 54% of women age 65 and older reported ever having received a pneumococcal vaccination18. Rates of pneumococcal vaccines are similar for men and women - but vary greatly between races19. Among adults 65 years of age and older, 39% of African American/Black, non-Hispanic adults and 42% of Hispanic or Latino adults reported ever having received a pneumococcal vaccine, compared to 64% of White adults of the same age group20.

An annual influenza vaccination is also recommended for all persons 65 years of age and over. It offers substantial protection against complications from the influenza virus21. In 2000, 63% of women over the age of 65 had received an influenza vaccine during the past 12 months22. Among adults 65 years of age and older, 48% of African American/Black, non-Hispanic adults and 55% of Hispanic or Latino adults, compared to 67% of White adults of the same age group, reported having received a flu vaccine within the past 12 months23.

B. Cervical Cancer Screenings

Large percentages of minority women reported that they had not been screened for cervical cancer within the past year: 51% of Asian American women, 37% of Hispanic women, and 27% of African American women24. (Of White women, 36% did not have a Pap smear during that period of time.)25 Use of preventive services by all women also differs significantly depending on their insured status. In 1997, 62% of women with health insurance had a Pap test in the past year, while only 48% of women without health insurance had a Pap test26.

More African American women (73%) had a cervical cancer screening than any other group of females, including White women. Asian American women were the least likely to have had a Pap test of all women, as less than one-half had reported being screened.

C. Breast Cancer Screenings

In 1997, many minority women aged 40 and over had not had a mammogram in the past two years: 27.5% of Asian/Pacific Islander women, 27.1% of African American women, and 33% of Hispanic women27. Among American Indian/Alaskan Native women aged 40 and over, 40.1% had not had a mammogram in the last 2 years28. (Among White women aged 40 and over, 28.6% had not had a mammogram in the past 2 years.)29

Among all women age 40 and over, more White women reported having had a mammogram (72.9%) than did minority populations. Among minority women age 40 and over, more than half in each racial/ethnic group reported having had a mammogram during the past two years.

D. Blood Pressure Screenings

Among all women, American Indian/Alaskan Native women were the least likely to have had a blood pressure screening, with only 27% reporting that they have had such a test within the past 12 months - A larger proportion of African American women (82%) had a blood pressure screening in the past year compared to any other group of women.

Of Hispanic and Asian American women, approximately 26% and 27% had not had a blood pressure screening in the past 12 months. In contrast, 20% of White women and 18% of African American women reported that they have not had a blood pressure screening30. A staggering 73% of American Indian/Alaskan Native women have not had a blood pressure screening in the past 12 months31.

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July, 2003