Sociodemographic Differences in Use of Preventive Services by Women Enrolled in Medicare+Choice Plans

The current study examined the role of demographic and socioeconomic factors, such as race, wealth, and income, on older adults' use of preventive health services. The study participants were 2,968 women 65 years of age and older enrolled in two Medicare+Choice health maintenance organizations (HMOs). A stratified random sampling method was employed to obtain study participants. Individuals were surveyed by telephone and administrative files from the health plans focused upon in the study were also examined. The Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) measured health status. Statistical analyses conducted included multivariate regression and ordinal logistic models. Independent variables included various categories of age, race, marital status, educational attainment, household income, and household wealth. Dependent variables were whether participants received mammography, colorectal cancer (CRC) screening, or vaccinations. Women over age 75 were less likely to have a mammogram or receive preventive health care services than women between 65-69 years of age. Women in the higher percentiles of household wealth were more likely than those at the lower percentiles to receive mammography and preventive services. Women with higher educational attainment also received more preventive services than women with lower educational attainment. Black women were more likely than white women to receive CRC screenings, as were women at higher household wealth and educational attainment. Black women were less likely than white women to receive vaccinations. Believing more strongly in formal medical care and having higher mental health scores were related to getting more preventive services. Results of the study illustrate that use of preventive services by older adults continues to vary by demographic and socioeconomic constructs.