Ethnicity & health · 2026
Racial residential segregation and receipt of breast cancer screening in the United States: a national cross-sectional study, 2020.
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Mahmood Asos, Kim Hyunmin, Chang Cyril F, Dike Aimee, Pawar Sushil
Аннотация
OBJECTIVES: Breast cancer is the most common cancer among the U.S. women, with a lifetime risk that exceeds 13%. In 2026, it is projected that approximately 321,910 new cases of invasive breast cancer will be diagnosed. While there are many well-known barriers to breast cancer screening, the effect of residential segregation on access to screening services is not fully understood.
DESIGN: This study utilized data from the 2020 U.S. Health Information National Trends Survey Data Linkage Project (HDLP2020) for 1329 women aged 40-75 years. Fitting generalized linear models with the maximum likelihood estimation, we explored the relationship between residential segregation and mammography screening rates. Secondary analyses examined the role of race (White vs. non-White) and rural-urban status in these associations.
RESULTS: Women in higher residential segregation were less likely to have undergone mammography in the past year, relative to those in less segregated areas (adjusted odds ratio [OR] = 0.40; 95% CI: 0.16-0.97; p-value = 0.04). Non-White women in moderately segregated regions also exhibited lower screening rates than those in low-segregation areas. Additionally, women in highly segregated urban settings were less likely to report mammography screening than their counterparts in less segregated urban areas (adjusted OR = 0.39; 95% CI: 0.16-0.92; p-value = 0.03).
CONCLUSION: The findings demonstrate that in more racially segregated communities, women are less likely to receive screening mammograms, particularly those who are non-White and live in urban settings. Efforts to improve breast cancer screening may account for the contextual and community determinants of health and address the specific needs of women in moderately to highly segregated areas to potentially reduce disparities and promote health equity.
DESIGN: This study utilized data from the 2020 U.S. Health Information National Trends Survey Data Linkage Project (HDLP2020) for 1329 women aged 40-75 years. Fitting generalized linear models with the maximum likelihood estimation, we explored the relationship between residential segregation and mammography screening rates. Secondary analyses examined the role of race (White vs. non-White) and rural-urban status in these associations.
RESULTS: Women in higher residential segregation were less likely to have undergone mammography in the past year, relative to those in less segregated areas (adjusted odds ratio [OR] = 0.40; 95% CI: 0.16-0.97; p-value = 0.04). Non-White women in moderately segregated regions also exhibited lower screening rates than those in low-segregation areas. Additionally, women in highly segregated urban settings were less likely to report mammography screening than their counterparts in less segregated urban areas (adjusted OR = 0.39; 95% CI: 0.16-0.92; p-value = 0.03).
CONCLUSION: The findings demonstrate that in more racially segregated communities, women are less likely to receive screening mammograms, particularly those who are non-White and live in urban settings. Efforts to improve breast cancer screening may account for the contextual and community determinants of health and address the specific needs of women in moderately to highly segregated areas to potentially reduce disparities and promote health equity.