More Than Income or Education, Where a Woman Lives Determines Her Use of Preventive Care Medicine

A study conducted by researchers at the Columbia University School of Nursing in New York City shows where a woman lives influences her use of preventive health care more than her income or education.

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. These characteristics also showed a correlation for greater participation in general preventive care such as checkups, and blood pressure, and cholesterol checks. But neighborhoods themselves showed the strongest association, according to the study.

Cindy Veldhuis, a postdoctoral research fellow at Columbia and the lead author of the study, observes that “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.”

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. But skipping preventive measures like Pap smears increases women’s risk of morbidity and mortality from conditions like cervical cancer. “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 says.

Dr. Veldhuis holds a bachelor’s degree 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 full 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.