TY - JOUR
T1 - Effect of health care system distrust on breast and cervical cancer screening in Philadelphia, Pennsylvania
AU - Yang, Tse Chuan
AU - Matthews, Stephen A.
AU - Hillemeier, Marianne M.
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Objectives: We investigated whether health care system distrust is a barrier to breast and cervical cancer screening and whether different dimensions of distrust-values and competence-have different impacts on cancer screening. Methods: We utilized data on 5268 women aged 18 years and older living in Philadelphia, Pennsylvania, and analyzed their use of screening services via logistic and multinomial logistic regression. Results: High levels of health care system distrust were associated with lower utilization of breast and cervical cancer screening services. The associations differed by dimensions of distrust. Specifically, a high level of competence distrust was associated with a reduced likelihood of having Papanicolaou tests, and women with high levels of values distrust were less likely to have breast examinations within the recommended time period. Independent of other covariates, individual health care resources and health status were associated with utilization of cancer screening. Conclusions: Health care system distrust is a barrier to breast and cervical cancer screening even after control for demographic and socioeconomic determinants. Rebuilding confidence in the health care system may improve personal and public health by increasing the utilization of preventive health services.
AB - Objectives: We investigated whether health care system distrust is a barrier to breast and cervical cancer screening and whether different dimensions of distrust-values and competence-have different impacts on cancer screening. Methods: We utilized data on 5268 women aged 18 years and older living in Philadelphia, Pennsylvania, and analyzed their use of screening services via logistic and multinomial logistic regression. Results: High levels of health care system distrust were associated with lower utilization of breast and cervical cancer screening services. The associations differed by dimensions of distrust. Specifically, a high level of competence distrust was associated with a reduced likelihood of having Papanicolaou tests, and women with high levels of values distrust were less likely to have breast examinations within the recommended time period. Independent of other covariates, individual health care resources and health status were associated with utilization of cancer screening. Conclusions: Health care system distrust is a barrier to breast and cervical cancer screening even after control for demographic and socioeconomic determinants. Rebuilding confidence in the health care system may improve personal and public health by increasing the utilization of preventive health services.
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U2 - 10.2105/AJPH.2010.300061
DO - 10.2105/AJPH.2010.300061
M3 - Article
C2 - 21566035
AN - SCOPUS:79958865816
SN - 0090-0036
VL - 101
SP - 1297
EP - 1305
JO - American journal of public health
JF - American journal of public health
IS - 7
ER -