Inequities in health screenings

Health screenings are a vital part of maintaining health, however, not everyone gets theirs done. I have seen individuals who avoid their health screenings due to their insurance not covering them or not having insurance in general. Aside from monetary issues, health literacy also plays a role. Many people are not aware of the risks and consequences that can accrue when they are not regularly screened for ailments. The combination of avoiding health screening due to lack of health education, low-income and being uninsured all contribute to early mortality.

Two very important health screenings for women are Pap smears and mammograms. Pap smear tests can be done from the age of 21 years¹ and mammograms from 40 years.² However, many women are not aware of when they should be getting screened. This is not commonly taught in schools except where students are working towards a healthcare field themselves. In my experience, my peers lack general knowledge about cancer screening and prevention as well.

Language barriers also contribute to fewer women getting screened. In English-speaking countries, those with limited English proficiency can have difficulty communicating with their healthcare provider without the aid of an interpreter. This stunts the quality of care they get during their visit. Where there is a lack of communication, there is a lack of connection, which hurts the patient in the long run.

Additionally, while some women may be asked by their primary care provider to get screened, they may not have access to screening services. This may be due to the patient living in an area where such services are not available, not having access to a doctor, or being uninsured. Those who are not getting check-ups regularly are not being told what screenings they are due for, what signs and symptoms they should watch out for, and what risk factors they may have for potential illnesses. A lack of understanding of disease prevention can play just as much of a role as other risk factors.

To increase the number of women who receive mammograms and Pap smears in the United States of America, the Centers for Disease Control has established the National Breast and Cervical Cancer Early Detection Programme across all states, territories and tribes. This programme assists women who are uninsured, have low income and have underserved access to healthcare.³ Through this programme, women may be eligible to receive a screening free of charge or at a low price. Another way to increase the number of screenings is to increase general knowledge regarding cancer screening and preventive measures. If this information is introduced in school settings, it sets the foundation for knowledge and encourages individuals to take care of themselves for the future. Moreover, creating educational resources in multiple languages can help increase health literacy and enhance understanding of the importance of these screenings in patients with limited English proficiency. This can ultimately prevent future health conditions and identify potential cancers before they can progress.

References

1. Renbaum B. How often do I need a Pap smear? Johns Hopkins Medicine, Based in Baltimore, Maryland, 19 July 2021. Available from: https://www.hopkinsmedicine.org/signature_obgyn/patient_information/ask_expert/gynecology-q-a/how-often-do-I-need-a-pap-smear.html.
2. Cancer screening guidelines: Detecting cancer early. American Cancer Society.Available from: https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html.
3. About the National Breast and Cervical Cancer Early Detection Program. Centers for Disease Control and Prevention, 15 February 2022. Available from: https://www.cdc.gov/cancer/nbccedp/about.htm.