Identifying Barriers that Discourage Unmarried Latina Women from Utilizing Cancer Screening Services
May 18, 2010
Photo by Melanie Wasserman
A 2004 U.S. Census Bureau study projected that by the year 2050, one in four women in the United States will be Hispanic. A growing number of these women are entering their retirement years unmarried. Additionally, data from the Behavioral Risk Factor Surveillance system suggest that unmarried Latina women have lower cancer screening rates than other groups, as defined by race, ethnicity and marital status.
To understand the reasons for this disparity, and to explore possible intervention strategies, the National Institute on Aging (NIA) awarded a grant to Abt Associates to study the barriers that deter older, unmarried Latina women from accessing preventive health services such as cancer screening tests.
"As the population of aging, unmarried Latina women increases, the need for accessible preventive health care becomes an issue of vital importance," says Abt Associates Project Director Melanie Wasserman. "Our study identifies some important barriers to access and proposes recommendations for more successful outreach."
Research Approach
Thirty-three Latina women, with limited English proficiency, and ranging in age from 40 to 75, participated in the study. Radio-based announcements supported recruiting and screening, and a photographic prompt method was used to elicit detailed narratives related to healthcare use and cancer screening utilization. A full description of the research approach is summarized here.
"As the population of aging, unmarried Latina women increases, the need for accessible preventive care becomes an issue of vital importance," concludes Wasserman. "Our study points out some important barriers to access and proposes recommendations for more successful outreach."
The study identified several key barriers that deter unmarried Latina women from accessing health care:
Lack of insurance/cost
Lack of logistical support
Lack of material aid
Lack of moral support
The issue of "resilience" also emerged as a key factor. "Low resilience can lead to trouble negotiating social situations, which can impact the likelihood of attaining marriage and accessing resources, such as health care," notes Wasserman.
Recommendations for Intervention Strategies and Policy Implications
Based on the interviews and data analysis, Wasserman's research team identified outlets through which the health care system can more successfully reach out to never married, middle-aged and older Latina women with information about screening services:
Mass media
Providers
Schools
Brochures
Health fairs
Photo by Melanie Wasserman
Another successful strategy is to partner with existing, familiar and trusted service providers in the community (e.g., food pantries, social workers, mental health services, job training programs),
or to reach Latinas through work or one-stop-shop community advocacy agencies.
Most importantly, the team concluded that when a never married Latina woman seeks health care, and in particular cancer screening, it is essential that she encounter a welcoming and supportive health care staff. This factor makes a striking impact on the woman's experience and her likelihood to repeat access to health care screening.
Impacting Health Policy
The results of this research study will be presented in a final report to the National Institute on Aging, and published in a peer reviewed journal. The conclusions may inform future NIA health policy and health care facilities' outreach strategies in primarily Latino neighborhoods.
