Do Contextual Conditions Moderate the Relationship between Race/Ethnicity and Mammogram Utilization?

Shannon M. Monnat, University of Nevada, Las Vegas

From a large U.S. sample of white, black, and Hispanic women aged 40-84 I use multilevel models to examine the relationship between individual race and county disadvantage on odds of having a recent mammogram. I find that black and Hispanic women are significantly more likely than white women to have had a mammogram within the past two years, and for all three groups of women, county-level economic disadvantage is inversely associated with mammogram utilization. I also find that living in counties with moderate percent black populations or large physician supplies is positively associated with utilization. The findings do not support the idea that women of color living in disadvantaged communities suffer from differential vulnerability when it comes to obtaining mammograms. Although race does have a greater influence on mammogram utilization in some counties than in others, this variation is not explained by the county-level disadvantage variables included in this analysis.