Socioeconomic status and access to health care are the most significant social determinants hindering breast cancer screening among women aged 40 and older in the United States, according to a new study from Florida Atlantic University’s Schmidt College of Medicine.
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The scoping review, published in Frontiers in Public Health, analyzed 72 peer-reviewed observational studies from 2013 to 2023. It found that factors related to socioeconomic status, including income, education level, and employment status, were most frequently associated with low screening rates.
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Access to health care emerged as a statistically significant theme in 61 percent of the studies, with insurance status being the most reported sub-category. Many studies demonstrated a strong link between lack of health insurance and lower breast cancer screening rates.
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Race and ethnicity also played a crucial role. Ethnic minority women, except those identifying as Asian, had a lower likelihood of being screened. Black women faced a higher risk of diagnosis upon first screening.
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“One of the most influential roles of social determinants of health lies within the realm of equitable access,” said Dr. Lea Sacca, senior author and assistant professor at FAU.
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The study highlighted disparities in screening rates based on income levels. Women with estimated household incomes above $38,100 had higher rates of repeat mammography compared to those below $25,399.
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Food insecurity was another influential factor. “Women facing food insecurity have a 54 percent lower likelihood of getting a mammogram,” Sacca noted.
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Researchers suggest that improving patient-provider communication, addressing perceived discrimination, and enhancing trust in the healthcare system could help improve screening rates across all demographics.
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See “Study Underscores Social Factors of Low Breast Cancer Screening in the U.S.” (March 4, 2024)


