Racial and/or Ethnic Differences in Adherence to Preventive Care Guidelines among US Adults Using a Nationally Representative Survey of All Eight Major Racial and/or Ethnic Populations.

BACKGROUND

Preventive care, like cancer screenings, is an effective tool to reduce the risk of morbidity and mortality. Despite these benefits, preventive care is underutilized in the United States and disparities are well-documented. However, preventive care research has largely been limited to Black, Latino, and White populations, and a better understanding of preventive care use across all racial and/or ethnic populations is needed.

METHODS

This study used data from the PREVentive Care AdheREnce in Diverse Populations (PREV-CARE) study, a nationally representative, online survey of American Indian or Alaska Native (AIAN), Asian, Black, Latino (English- and Spanish-speaking), Middle Eastern or North African (MENA), Native Hawaiian or Pacific Islander (NHPI), White, and multiracial adults aged ≥35 years (6/2023-8/2023, N=4,111). Preventive care measures included blood pressure screening; cholesterol screening; breast, cervical, and colorectal cancer screening; and influenza, shingles vaccination, and pneumococcal vaccination. Multivariable Poisson regression was used to estimate the association between race and/or ethnicity and adherence to preventive services guidelines. Ethnicity-stratified analyses among Asian, Latino, and NHPI participants were also performed.

RESULTS

Several disparities in vaccination adherence were observed when compared to White adults, among AIAN (influenza PR: 0.82 [95% CI:0.69-0.98]; shingles PR: 0.76, [0.54-1.08]), Black (shingles PR: 0.75, [0.54-1.06]), Spanish-speaking Latino (pneumococcal PR: 0.78 [0.51-1.19]), MENA (influenza PR: 0.75 [0.62-0.92]), and multiracial adults (influenza PR: 0.84 [0.71-1.00]; shingles PR: 0.53 [0.34-0.81]). MENA females were also less likely to undergo cervical cancer screening (PR: 0.85 [0.62-0.92]). Almost all racial and/or ethnic populations were below Healthy People 2030 targets.

CONCLUSIONS

Future research should assess how health beliefs and barriers to care contribute to racial and/or ethnic disparities in preventive care.