Distance and Mammogram Utilization among Unmarried Middle-Aged and Older Women

Melanie R. Wasserman, Brown University
Steven Meersman, National Cancer Institute, NIH
William Rakowski, Brown University
Melissa A. Clark, Brown University

This study assessed the relationship between distance to mammography facilities and mammography utilization among unmarried women age 40-75 in Rhode Island, using data from the Cancer Screening Project for Women (N=568). ARC/GIS was used to calculate distance between women's exact home addresses and nearest mammography facility. Distance was split into tertiles, and three logistic regression models of recent mammography (past 2 years) were computed: (1) distance variables only; (2) model 1 plus individual-level variables; and (3) model 2 plus neighborhood-level variables. Greater distance was significantly positively associated with recent mammography, but only in model 1 (tertile 2 OR=1.76, CI=1.00-3.09; tertile 3 OR=2.37, CI=1.29-4.33). Results suggest that in small, densely populated areas, greater distance does not, in and of itself, affect mammography utilization. In these areas, GIS may best be used as a tool to assess the compositional differences accounting for underserved areas, so that tailored interventions may be designed.