Pathways to colonoscopy in the South: Seeds of health disparities

B.A. Curbow, A.B. Dailey, E.C. King-Marshall, T.E. Barnett, J.R. Schumacher, S. Sultan and George, T.J.,

American Journal of Public Health, 2015, vol. 105, issue 4, e103-e111

Abstract: Objectives. We aimed to highlight sociodemographic differences in how patients access colonoscopy. Methods. We invited all eligible patients (n=2500) from 2 academy-affiliated colonoscopy centers in Alachua County, Florida (1 free standing, 1 hospital based), to participate in a precolonoscopy survey (September 2011-October 2013); patients agreeing to participate (n=1841, response rate =73.6%) received a $5.00 gift card. Results. We found sociodemographic differences in referral pathway, costs, and reasons associated with obtaining the procedure. Patients with the ideal pathway (referred by their regular doctor for age-appropriate screening) were more likely to be Black (compared with other minorities), male, high income, employed, and older. Having the colonoscopy because of symptoms was associated with being female, younger, and having lower income. We found significant differences for 1 previously underestimated barrier, having a spouse to accompany the patient to the procedure. Conclusions. Patients' facilitators and barriers to colonoscopy differed by sociodemographics in our study, which implies that interventions based on a single facilitator will not be effective for all subgroups of a population. © 2015, American Public Health Association Inc. All rights reserved.

Keywords: African American; age; ancestry group; colonoscopy; Colorectal Neoplasms; early diagnosis; epidemiology; ethnology; female; health care cost; health care delivery; Hispanic; human; male; patient referral; sex difference; socioeconomics; statistics and numerical data; United States, African Americans; Age Factors; Colonoscopy; Colorectal Neoplasms; Continental Population Groups; Early Detection of Cancer; Female; Florida; Health Expenditures; Health Services Accessibility; Hispanic Americans; Humans; Male; Referral and Consultation; Sex Factors; Socioeconomic Factors (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302347_4

DOI: 10.2105/AJPH.2014.302347

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