The Roles of Citizenship Status, Acculturation, and Health Insurance in Breast and Cervical Cancer Screening Among Immigrant Women

The current study examined disparities in Papanicolaou (Pap) smear and mammography screening for immigrant and U.S.-born women. Participants were 18,342 women (of which 1,445 were noncitizens) from a nationally representative sample from the 2000 National Health Interview Survey. Acculturation was assessed for the Latina participants.

Key Findings:

  • Even when sociodemographic factors, such as age and income, were controlled for in the analysis, U.S.-born women were significantly more likely to report a mammography screening than noncitizens.
  • Disparities in mammography screening between U.S.-born and noncitizen women decreased when health insurance and having consistent care were adjusted for in the analysis.
  • In regard to Pap smears, even when controlling for consistent health care and sociodemographic factors, significant disparities existed between women based on citizenship status.
  • For the Latina subsample, disparities in Pap smear screening continued after controlling for sociodemographics and having consistent health care. After adjusting for acculturation the disparity between U.S.-born and noncitizen women no longer existed.
  • Given the role of acculturation and impact of having consistent health care on reports of undergoing Pap smear and mammography screening, community interventions that addressed culture might be helpful in reducing disparities due to citizenship status.