Year of Publication

2016

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Sarah Wackerbarth, PhD

Committee Member

Kevin Pearce, MD, MPH

Committee Member

Stephen Wyatt, DMD, MPH

Abstract

Introduction

Breast cancer and adequate screening remains a significant scientific, clinical and societal challenge both in Kentucky and in the U.S. To date, the lack of medical insurance has been implicated as a barrier to the provision of breast cancer screening not only to those within the Commonwealth of Kentucky but amongst the general population of the United States.

Methods

The Kentucky Department of Health provided study data utilized in our analysis. The data requested consisted of Medicaid claims for mammography screens for all counties in the Commonwealth of Kentucky. In addition, data gathering occurred via interviews with four Mobile Mammography Units operating within and contracted with the state for breast cancer screening services.

Results

Across all 120 counties in the Commonwealth, the average percentage of women eligible for screening mammograms who received screening mammograms through Medicaid was 28.2%. The major gaps identified were: (1) Implementing sustainable growth strategies (2) The need for tailored screening approaches to increase screening rates (3) Developing interventions and support networks for programs in the Commonwealth that endorse common guidelines and practices.

Conclusions

As the Commonwealth of Kentucky works towards achieving increased mammography screening rates for its residents, continued support for the reduction of screening barriers through mobile services is recommended. Additionally, a focused effort to improve health literacy and extend the reach for those women with language, geographic, and economic barriers would be of benefit.

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