Preventive Health Screening Disparities by Disability, Gender and Race

Friday, 26 July 2013: 8:30 AM

Suzanne C. Smeltzer, EdD, RN, MS, FAAN
College of Nursing, Villanova University, Villanova, PA

Learning Objective 1: describe health disparities affecting people with disabilities by gender and race

Learning Objective 2: discuss health care disparities in preventive health screening in Caucasian and African-American men and women with disabilities

Purpose: Health disparities are common among racial minority groups and people with disabilities. With growing populations of people with disabilities and racial ethnic minorities, there is a need to examine disparities in health screening among African-American (AA) and Caucasian populations if these disparities are to be reduced.  This study compared health disparities in preventive health screening in African-Americans and Caucasians with disabilities.

Methods: Goodall’s Interface model of disability provided a framework to address factors affecting health of people with disabilities, including gender and race. A descriptive, comparative study used secondary analysis of the 2008 National Health Interview Survey (NHIS) data. The sample included 19,998 AA and Caucasian men and women who completed the survey in 2008. De-identified data were analyzed using chi square with p value < .05. 

Results: The sample included 11,302 (56.6%) women and 8,696 (43.5%) men; 18.9% were AA women and 15% AA men. Limitations were reported by 40% of women and 29.2% of men. The prevalence of disability differed  by gender and race; women and AAs reported more limitations than men and Caucasian women. There were no differences in PSA screening and fecal occult blood testing in AA and Caucasian men by disability status. There were, however, differences in Pap testing and mammography in AA vs. Caucasian women; AA women with disabilities reported less frequent Pap testing and mammography than Caucasians with disabilities (p=.000 and .004, respectively).

Conclusions: AA women with disabilities are less likely than Caucasian women with disabilities to undergo preventive health screening. Because AA women have higher mortality rates than Caucasians and preventive screening is obtained less often in those with disabilities, there is a need to identify strategies to encourage women with disabilities, particularly AA women, to have preventive health screening and to ensure accessibility facilities for screening to occur.