Elsevier

Women's Health Issues

Volume 26, Issue 2, March–April 2016, Pages 196-200
Women's Health Issues

Geography
Perceptions of One's Neighborhood and Mammogram Use among a Sample of Low-Income Women at Risk for Human Immunodeficiency Virus and Sexually Transmitted Infections

https://doi.org/10.1016/j.whi.2015.08.005Get rights and content

Abstract

Background

Neighborhood disorder, signs of physical and social disorganization, has been related to a range of poor mental and physical health outcomes. Although individual factors have been widely associated with getting a mammogram, little is known about the impact of the neighborhood environment on a woman's decision to get a mammogram.

Methods

In a sample of women at risk for human immunodeficiency virus and sexually transmitted infections, we explored the role of perceptions of one's neighborhood on getting a mammogram. The study included two samples: women 40 to 49 years (n = 233) and women 50 years and older (n = 83). Data were collected from May 2006 through June 2008.

Results

Women age 50 years and older who lived in a neighborhood with disorder were 72% less likely to get a mammogram compared with women who lived in neighborhoods without disorder. There was no relationship for women age 40 to 49 years.

Conclusions

Interventions are needed to increase awareness and encourage women living in neighborhoods with disorder to get a mammogram. In addition to interventions to increase mammography, programs are needed to decrease neighborhood disorder. Increasing neighborhood cohesion, social control, and empowerment could integrate health promotion programs to both reduce disorder and increase health behaviors.

Section snippets

Methods

Data for this study were collected from participants in the CHAT study, a social network-oriented HIV prevention intervention. Participants were recruited through street outreach, newspaper advertisements, and referrals from community agencies. Because the focus of the parent study was on HIV prevention peer education, two types of study participants (Index and Network) were enrolled in the study. Inclusion criteria for index participants were female, aged 18 to 55 years old, did not inject

Results

Among women age 40 to 49 years, 66.1% (n = 154) reported getting a mammogram. Approximately 38% (n = 89) received a mammogram in the past year. Among women 50 years and older, 81.9% (n = 68) reported receiving a mammogram, of which 43.8% (n = 39) got it done in the past year. Sample characteristics are shown in Table 1. Among this low employment and income sample, more than one-half of respondents reported using any heroin or cocaine in the past 6 months. The vast majority of women reported

Discussion

In this study, we explored contextual effects on obtaining a mammogram among women in their 40s and 50 years and older. Living in an area with neighborhood disorder decreased the likelihood of women 50 years and older reporting that they had received a mammogram. There was no association for women 40 to 49 years old.

Our study expanded the literature on geography and mammography by focusing on perceptions of disorder in one's neighborhood rather than geographical location. Perceiving disorder in

Implications for Practice and/or Policy

Bowie, Wells, Juon, Sydnor, and Rodriguez (2008) found that being knowledgeable about screening guidelines increased the likelihood of getting a mammogram among women age 40 and older. Interventions are needed to increase awareness about the importance of cancer screening. Health care and social service providers may a crucial role in continuously encourage women to get a mammogram.

Other interventions are also promising. A recent review by Gardner, Adams, and Jeffreys (2013) found interventions

Melissa A. Davey-Rothwell, PhD, CHES, is Associate Scientist in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on social and contextual influences on health including the role of norms and the neighborhood environment.

References (46)

  • R. Miles

    Neighborhood disorder and smoking: Findings of a European urban survey

    Social Science & Medicine

    (2006)
  • D.D. Perkins et al.

    The physical environment of street blocks and resident perception of crime and disorder: Implications for theory and measurement

    Journal of Community Psychology

    (1992)
  • M. Ramos et al.

    Actitudes de las personas usuarias de atencion primaria ante el cribado del cancer colorrectal [Attitudes of primary health care users to a colorectal cancer screening program]

    Gaceta Sanitaria/S.E.S.P.A.S

    (2013)
  • L.E. Wee et al.

    Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention

    Preventive Medicine

    (2012)
  • A. Aggarwal et al.

    Are depressive symptoms associated with cancer screening and cancer stage at diagnosis among postmenopausal women? The Women's Health Initiative Observational Cohort

    Journal of Women's Health

    (2008)
  • T.F. Akinyemiju et al.

    Healthcare access and mammography screening in Michigan: A multilevel cross-sectional study

    International Journal for Equity in Health

    (2012)
  • American Cancer Society. (2013a). American Cancer Society guidelines for the early detection of cancer. Available:...
  • Breast cancer facts & figures 2013–2014

    (2013)
  • M.P. Andrasik et al.

    Barriers to cervical cancer screening among low-income HIV-positive African American women

    Journal of Health Care for the Poor and Underserved

    (2008)
  • A.R. Aro et al.

    Two distinct groups of non-attenders in an organized mammography screening program

    Breast Cancer Research and Treatment

    (2001)
  • M. Bergamini et al.

    Cervical cancer screening in the Ferrara Local Health Authority catchment area

    Journal of Preventive Medicine and Hygiene

    (2007)
  • J.V. Bowie et al.

    How old are African American women when they receive their first mammogram? Results from a church-based study

    Journal of Community Health

    (2008)
  • C.J. Bradley et al.

    Disparities in cancer diagnosis and survival

    Cancer

    (2001)
  • Cited by (3)

    Melissa A. Davey-Rothwell, PhD, CHES, is Associate Scientist in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Her research focuses on social and contextual influences on health including the role of norms and the neighborhood environment.

    Janice Bowie, PhD, is Associate Professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Her research examines factors associated with health disparities and community-based participatory research.

    Laura Murray, BA, BSN, was a research assistant in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. She recently received her nursing degree from the Johns Hopkins School of Nursing.

    Carl A. Latkin, PhD, is Professor, Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. His current research interests include U.S. and international approaches to behavior change, social network analysis, and neighborhood factors associated with health behaviors.

    Research Support: Research reported in this publication was supported by the National Institute on Mental Health (grant# R01 MH66810 and 1K01MH096611-01A1), and the National Institute on Drug Abuse (R01 DA016555) and the Johns Hopkins Center for AIDS Research (1P30AI094189). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    View full text