A study conducted by Columbia University School of Nursing shows where a woman lives influences her use of preventive health care more than her income or race/ethnicity.
Specific neighborhood characteristics — such as affluence, residential stability, and perceptions of neighborhood support and stress — showed a significant association with women’s use of sex-specific preventive care (such as Pap smears, breast exams, and mammograms) and general preventive care (such as checkups, and blood pressure, and cholesterol checks). But neighborhoods themselves showed the strongest association with women’s use of preventive care services.
Preventive care is key to health promotion and disease prevention, yet only 50 percent of adults in the United States receive recommended preventive care services. Moreover, women are more likely than men to skip or put off preventive care.
Cindy Veldhuis, a postdoctoral researcher at the Columbia Univerity School of Nursing and lead author of the study, explains that “overall, neighborhood has more of an association with a woman’s use of preventive care than depression, demographics, whether a woman has insurance or a primary care provider, or her level of income or education. This could be due to a variety of neighborhood factors, including segregation, community-level racism, discrimination, the quality of health care facilities, or residents’ trust in these health care facilities.”
Dr. Veldhuis stresses the importance of considering demographics, mental health, social networks, and neighborhood characteristics when targeting interventions to reduce disparities in the use of preventive care. “There is an overwhelming belief that women’s use of health care is not an issue, but our data suggests that they actually have high unmet needs for preventive care,” Dr. Veldhuis said.
Dr. Veldhuis holds a bachelor’s degree in psychology and theater and a master’s degree in cognitive psychology from the University of Oregon. She earned a Ph.D. in psychology at the University of Illinois at Chicago.
The study, “Psychological and Neighborhood Factors Associated With Urban Women’s Preventive Care Use,” was published in the Journal of Behavioral Medicine. It may be accessed here.