Table 4.
Association Between Woman and Community Level Factors and Self-Reported Barriers to Health Care, Breast Cancer Surveillance Consortium 2012–2017
| All |
Urban |
Nonurban |
||||
|---|---|---|---|---|---|---|
| % with barrier | aORa(95% CI) | % with barrier | aORa(95% CI) | % with barrier | aORa(95% CI) | |
| Woman level factors | ||||||
| Age group, years | ||||||
| 40–49 | 4.5 | 1.0 | 4.7 | 1.0 | 3.3 | 1.0 |
| 50–59 | 4.5 | 1.16 (1.09–1.23) | 5.0 | 1.21 (1.01–1.11) | 2.9 | 0.90 (0.77–1.05) |
| 60–69 | 2.9 | 0.81 (0.76–0.86) | 3.3 | 0.86 (0.66–0.73) | 1.7 | 0.59 (0.50–0.70) |
| 70–79 | 1.7 | 0.50 (0.45–0.55) | 1.9 | 0.55 (0.37–0.44) | 0.7 | 0.24 (0.17–0.32) |
| 80+ | 1.2 | 0.36 (0.30–0.44) | 1.4 | 0.40 (0.24–0.36) | 0.7 | 0.22 (0.13–0.38) |
| Race/Ethnicity | ||||||
| White | 2.9 | 1.0 | 3.0 | 1.0 | 2.0 | 1.0 |
| Black | 6.1 | 1.30 (1.16–1.44) | 6.2 | 1.29 (1.15–1.44) | 2.1 | 1.05 (0.48–2.30) |
| Asian | 3.3 | 0.80 (0.74–0.86) | 3.3 | 0.80 (0.74–0.86) | 3.3 | 1.31 (0.67–2.57) |
| Hispanic | 7.0 | 1.66 (1.53–1.80) | 7.0 | 1.64 (1.51–1.79) | 5.6 | 1.98 (1.40–2.81) |
| Other | 7.0 | 1.84 (1.65–2.04) | 7.2 | 1.75 (1.56–1.96) | 5.5 | 2.53 (1.84–3.47) |
| Education | ||||||
| <High school graduate | 4.8 | 1.11 (1.02–1.22) | 5.0 | 1.09 (0.99–1.20) | 2.7 | 1.23 (0.86–1.73) |
| High school graduate or GED | 3.0 | 0.91 (0.84–0.98) | 3.9 | 0.90 (0.83–0.98) | 1.8 | 0.96 (0.82–1.13) |
| Some college | 3.9 | 1.06 (1.00–1.12) | 4.4 | 1.03 (0.97–1.10) | 2.6 | 1.24 (1.07–1.44) |
| College graduate | 3.3 | 1.0 | 3.6 | 1.0 | 2.1 | 1.0 |
| Family history of breast cancer | ||||||
| No | 3.5 | 1.0 | 3.9 | 1.0 | 2.1 | 1.0 |
| Yes | 3.5 | 1.16 (1.09–1.23) | 3.8 | 1.15 (1.08–1.23) | 2.3 | 1.27 (1.09–1.48) |
| Personal history breast cancer | ||||||
| No | 3.6 | 1.0 | 3.9 | 1.0 | 2.2 | 1.0 |
| Yes | 3.0 | 1.35 (1.23–1.49) | 3.3 | 1.35 (1.22–1.50) | 1.8 | 1.43 (1.06–1.92) |
| Time since prior mammogram | ||||||
| No prior mammogram | 7.4 | 3.43 (1.34–8.79) | 7.5 | 3.21 (1.23–9.17) | b | b |
| 0–11 months | 2.9 | 1.17 (0.99–1.38) | 3.8 | 1.28 (1.07–1.54) | 1.3 | 0.93 (0.64–1.35) |
| 12–23 months | 2.3 | 1.0 | 2.6 | 1.0 | 1.5 | 1.0 |
| 24–35 months | 3.7 | 1.49 (1.41–1.57) | 3.8 | 1.45 (1.37–1.53) | 3.0 | 1.97 (1.68–2.31) |
| 36–47 months | 6.0 | 2.56 (2.36–2.78) | 6.5 | 2.52 (2.31–2.76) | 4.4 | 2.80 (2.27–3.46) |
| 48+ months | 7.8 | 3.37 (3.12–3.63) | 8.8 | 3.43 (3.16–3.73) | 5.0 | 3.00 (2.45–3.66) |
| Other breast imaging in prior year | ||||||
| No | 3.6 | 1.0 | 4.0 | 1.0 | 2.2 | 1.0 |
| Yes | 2.2 | 0.81 (0.64–1.03) | 2.5 | 0.78 (0.59–1.02) | 1.2 | 0.80 (0.46–1.37) |
| Community level factors | ||||||
| Median household income in census block | ||||||
| < $54,450 | 3.0 | 1.0 | 4.7 | 1.0 | 1.9 | 1.0 |
| $54,452–74,787 | 3.4 | 0.88 (0.81–0.95) | 3.9 | 0.87 (0.79–0.96) | 1.8 | 0.97 (0.80–1.17) |
| $74,816–101,408 | 3.3 | 0.78 (0.70–0.87) | 3.4 | 0.79 (0.70–0.89) | 2.1 | 0.89 (0.56–1.42) |
| > $101,408 | 2.5 | 0.69 (0.61–0.79) | 2.5 | 0.70 (0.61–0.81) | 2.0 | 1.08 (0.33–3.55) |
| Average health insurance costs in census block | ||||||
| < $1,828 | 3.4 | 1.0 | 4.7 | 1.0 | 1.9 | 1.0 |
| $1,828–2,281 | 3.1 | 0.96 (0.89–1.04) | 3.9 | 0.92 (0.84–1.01) | 1.9 | 1.01 (0.87–1.18) |
| $2,282–3,188 | 3.2 | 0.96 (0.87–1.06) | 3.4 | 0.93 (0.83–1.04) | 1.8 | 0.93 (0.71–1.22) |
| > $3,188 | 2.5 | 0.85 (0.74–0.98) | 2.5 | 0.82 (0.71–0.95) | 1.9 | 0.64 (0.29–1.41) |
| Proportion with Internet access in census block | ||||||
| <82 | 3.7 | 1.0 | 4.0 | 1.0 | 2.1 | 1.0 |
| 82–88 | 2.9 | 1.02 (0.96–1.10) | 4.1 | 1.07 (0.99–1.16) | 1.8 | 0.87 (0.74–1.03) |
| 89–94 | 2.6 | 0.91 (0.84–1.00) | 2.7 | 0.91 (0.83–1.00) | 1.9 | 0.87 (0.67–1.13) |
| >94 | 3.3 | 1.11 (1.02–1.21) | 3.3 | 1.12 (1.03–1.23) | 2.4 | 0.22 (0.07–0.72) |
| Unemployment rate in census block | ||||||
| <6.8 | 2.3 | 1.0 | 2.7 | 1.0 | 1.8 | 1.0 |
| 6.8–8.7 | 2.9 | 1.06 (0.98–1.13) | 3.1 | 1.04 (0.96–1.13) | 2.0 | 1.11 (0.96–1.29) |
| 8.8–11.3 | 3.2 | 0.99 (0.92–1.07) | 3.3 | 0.99 (0.91–1.08) | 1.9 | 0.99 (0.78–1.24) |
| >11.3 | 4.0 | 1.01 (0.93–1.09) | 4.2 | 1.02 (0.93–1.11) | 1.9 | 0.83 (0.63–1.09) |
| Proportion with households in which no adult speaks English very well in census tract | ||||||
| None | 2.8 | 1.0 | 3.2 | 1.0 | 1.9 | 1.0 |
| Any (>0%) | 3.9 | 1.02 (0.96–1.08) | 3.9 | 1.02 (0.96–1.08) | 5.0 | 0.79 (0.33–1.92) |
| Diversity index in census tract | ||||||
| <25 | 1.9 | 1.0 | 2.1 | 1.0 | 1.8 | 1.0 |
| 25–48 | 2.8 | 1.21 (1.06–1.39) | 2.8 | 1.20 (1.03–1.39) | 2.2 | 1.12 (0.76–1.64) |
| 49–63 | 3.2 | 1.17 (1.02–1.35) | 3.2 | 1.15 (0.99–1.35) | 2.5 | 1.79 (0.98–3.24) |
| >63 | 4.5 | 1.28 (1.11–1.48) | 4.5 | 1.26 (1.08–1.48) | 3.5 | 0.96 (0.53–1.74) |
Boldface values indicate statistical significance.
a
aOR: adjusted for all variables shown in table, as well as BCSC registry site and examination year. Examinations with missing covariates were excluded from the models.
b
No examinations in this category were retained in the model due to missing covariates.
aOR, adjusted odds ratio; BCSC, Breast Cancer Surveillance Consortium; CI, confidence interval.