Decreased Mammogram Use Correlate with Adverse Social Determinants of Health


Lack of health insurance and not having a healthcare provider are two of the biggest factors that contribute to skipping a mammogram.

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Nearly 40,000 women in the United States die from breast cancer every year. Mammography has decreased breast cancer rates significantly. Even so, some women don’t get regular mammograms.

To determine which factors are the biggest barriers to mammogram access, a research team led by Jacqueline Miller, M.D., a board-certified general surgeon and captain with the U.S. Public Health Service, combed through data from the 2022 Behavioral Risk Factor Surveillance System. They focused on mammography prevalence in women ages 40-74 and categorized them by jurisdiction, age and sociodemographic factors. The results were published in the CDC’s Morbidity and Mortality Weekly Report earlier this month.

In a sample that included just over 117,000 women, Miller and her team found that the proportion of mammogram use increased with age. In women ages 40-49, 59.1% had gotten a mammogram every two years. In women ages 50-74, that rate was 76.5%. Black women reported the highest rates of mammography in both age ranges at 65.2% and 82.9%.

Mammography use was lowest in women without health insurance (32.7% in women ages 40-49 and 37.4% in women ages 50-74) and those who did not have a healthcare provider (32.7% and 42.2%).

In women with health insurance, rates for each age group were at 58.7% and 73.9%. For women with a healthcare provider, rates were at 63.4% and 79.1%.

To combat these issues, the White House has released a social determinants of health playbook that, among other things, calls for calls for community funding and emphasizes a greater need for social services. Mammograms are also available at a low cost or no cost through insurance mandates under the Affordable Care Act, Medicare and the CDC’s National Breast and Cervical Cancer Early Detection Program.

In 2024, CMS also issued a new billing code that allows healthcare providers to be reimbursed for performing a social determinant of health analysis on patients.

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