{"title":"美国黑人妇女使用子宫颈抹片检查的社会经济不平等现象:交叉方法。","authors":"Sydney Fisher, Madina Agénor","doi":"10.1007/s40615-024-02148-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Research investigating racialized inequities in cervical cancer screening has rarely considered the influence of socioeconomic position (SEP), a key social determinant of health that intersects with race/ethnicity and racism. Thus, data on socioeconomic inequities in Pap test use within racialized groups-including Black women, who are at elevated risk of cervical cancer morbidity and mortality-are limited.</p><p><strong>Methods: </strong>Using 2011-2019 data from the National Survey of Family Growth and guided by an intersectional framework, we used multivariable logistic regression to examine the association between educational attainment, employment status, and income and the adjusted odds of Pap test use in the last 3 years among Black U.S. women.</p><p><strong>Results: </strong>Compared to Black women with a bachelor's degree or greater, those with less than a high school diploma ([odds ratio] = 0.45; [95% confidence interval] 0.31-0.67) and a high school diploma/GED (0.57; 0.40-0.81) had significantly lower odds of Pap test use, adjusting for sociodemographic factors. Unemployed women had significantly lower adjusted odds of Pap test use compared to employed women (0.67; 0.50-0.89), and women living below 100% of the federal poverty level (FPL) had significantly lower adjusted odds of Pap test use relative to those living at or above 300% FPL (0.63; 0.45-0.88).</p><p><strong>Conclusion: </strong>Low-SEP Black women had significantly lower adjusted odds of Pap test use relative to their higher SEP counterparts. Interventions that address both racism and economic barriers to care are needed to facilitate access to regular cervical cancer screening among low-SEP Black women.</p>","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Socioeconomic Inequities in Pap Test Use Among Black Women in the United States: An Intersectional Approach.\",\"authors\":\"Sydney Fisher, Madina Agénor\",\"doi\":\"10.1007/s40615-024-02148-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Research investigating racialized inequities in cervical cancer screening has rarely considered the influence of socioeconomic position (SEP), a key social determinant of health that intersects with race/ethnicity and racism. Thus, data on socioeconomic inequities in Pap test use within racialized groups-including Black women, who are at elevated risk of cervical cancer morbidity and mortality-are limited.</p><p><strong>Methods: </strong>Using 2011-2019 data from the National Survey of Family Growth and guided by an intersectional framework, we used multivariable logistic regression to examine the association between educational attainment, employment status, and income and the adjusted odds of Pap test use in the last 3 years among Black U.S. women.</p><p><strong>Results: </strong>Compared to Black women with a bachelor's degree or greater, those with less than a high school diploma ([odds ratio] = 0.45; [95% confidence interval] 0.31-0.67) and a high school diploma/GED (0.57; 0.40-0.81) had significantly lower odds of Pap test use, adjusting for sociodemographic factors. Unemployed women had significantly lower adjusted odds of Pap test use compared to employed women (0.67; 0.50-0.89), and women living below 100% of the federal poverty level (FPL) had significantly lower adjusted odds of Pap test use relative to those living at or above 300% FPL (0.63; 0.45-0.88).</p><p><strong>Conclusion: </strong>Low-SEP Black women had significantly lower adjusted odds of Pap test use relative to their higher SEP counterparts. Interventions that address both racism and economic barriers to care are needed to facilitate access to regular cervical cancer screening among low-SEP Black women.</p>\",\"PeriodicalId\":16921,\"journal\":{\"name\":\"Journal of Racial and Ethnic Health Disparities\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Racial and Ethnic Health Disparities\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40615-024-02148-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Racial and Ethnic Health Disparities","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40615-024-02148-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
导言:调查宫颈癌筛查中种族不平等现象的研究很少考虑社会经济地位(SEP)的影响,而社会经济地位是健康的一个关键社会决定因素,与种族/民族和种族主义相互交织。因此,有关种族化群体(包括宫颈癌发病率和死亡率风险较高的黑人妇女)使用巴氏试验的社会经济不平等现象的数据非常有限:方法:我们利用全国家庭成长调查(National Survey of Family Growth)中的 2011-2019 年数据,在交叉框架的指导下,使用多变量逻辑回归法研究了美国黑人妇女的教育程度、就业状况和收入与最近 3 年使用巴氏检查的调整后几率之间的关系:结果:与拥有学士学位或更高学历的黑人妇女相比,高中以下文凭([几率比]=0.45;[95% 置信区间]0.31-0.67)和高中文凭/普通教育(0.57;0.40-0.81)的妇女使用巴氏检查的几率明显较低,并对社会人口因素进行了调整。与就业妇女相比,失业妇女使用巴氏试验的调整后几率明显较低(0.67;0.50-0.89),与生活在联邦贫困线(FPL)300%或以上的妇女相比,生活在联邦贫困线100%以下的妇女使用巴氏试验的调整后几率明显较低(0.63;0.45-0.88):结论:与生活水平较高的黑人妇女相比,生活水平较低的黑人妇女使用巴氏试验的调整几率明显较低。需要采取干预措施来解决种族和经济方面的医疗障碍,以促进低收入黑人妇女定期接受宫颈癌筛查。
Socioeconomic Inequities in Pap Test Use Among Black Women in the United States: An Intersectional Approach.
Introduction: Research investigating racialized inequities in cervical cancer screening has rarely considered the influence of socioeconomic position (SEP), a key social determinant of health that intersects with race/ethnicity and racism. Thus, data on socioeconomic inequities in Pap test use within racialized groups-including Black women, who are at elevated risk of cervical cancer morbidity and mortality-are limited.
Methods: Using 2011-2019 data from the National Survey of Family Growth and guided by an intersectional framework, we used multivariable logistic regression to examine the association between educational attainment, employment status, and income and the adjusted odds of Pap test use in the last 3 years among Black U.S. women.
Results: Compared to Black women with a bachelor's degree or greater, those with less than a high school diploma ([odds ratio] = 0.45; [95% confidence interval] 0.31-0.67) and a high school diploma/GED (0.57; 0.40-0.81) had significantly lower odds of Pap test use, adjusting for sociodemographic factors. Unemployed women had significantly lower adjusted odds of Pap test use compared to employed women (0.67; 0.50-0.89), and women living below 100% of the federal poverty level (FPL) had significantly lower adjusted odds of Pap test use relative to those living at or above 300% FPL (0.63; 0.45-0.88).
Conclusion: Low-SEP Black women had significantly lower adjusted odds of Pap test use relative to their higher SEP counterparts. Interventions that address both racism and economic barriers to care are needed to facilitate access to regular cervical cancer screening among low-SEP Black women.
期刊介绍:
Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.