Neighborhood Deprivation and Screening Mammography Utilization: A Retrospective Cross-Sectional Study
In brief
Women in high-deprivation neighborhoods are about 10% less likely to receive screening mammograms
In a Midwest accountable care network, 74% of women aged 40-85 had a mammogram within two years, but rates fell from 76% in low-deprivation areas to 66% in high-deprivation areas. After adjusting for age, race, ethnicity and language, neighborhood disadvantage remained a strong predictor, highlighting the need for targeted equity interventions.
- Journal
- Academic radiology (Q1)
- Published
- 1 September 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Lewis Jordan, Amina Karage, Robin Lankton, Shiva Bidar-Sielaff, Mai Elezaby, Anand Narayan
- PMID
- 42680655
- DOI
- 10.1016/j.acra.2026.07.056
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 3 September 2026): Neighborhood deprivation linked to lower mammography use
Abstract
RATIONALE AND OBJECTIVES: Access to screening mammography reduces breast cancer mortality disparities. The Area Deprivation Index (ADI) is a validated measure of neighborhood socioeconomic disadvantage linked to adverse health outcomes. There is limited data evaluating mammography utilization among patients residing in areas of higher deprivation. This study evaluated the association between ADI and screening mammography utilization within an accountable care organization (ACO) affiliated with a multicenter academic medical center in the Upper Midwest. METHODS: This retrospective cross-sectional study included women aged 40-85 years attributed to the ACO in 2022, based on Wisconsin Collaborative for Healthcare Quality criteria. The primary outcome was receipt of screening mammography within two years. The primary exposure was ADI, analyzed by decile (ordinal) and as low (deciles 1-5) versus high (deciles 6-10) deprivation. The logistic regression models evaluated associations between ADI and screening, unadjusted and adjusted for age, race, ethnicity, and preferred language. RESULTS: Among 7463 participants with geographic data, 74.4% completed screening. Screening rates were 75.7% in low-deprivation areas versus 66.2% in high-deprivation areas. Increasing ADI decile was associated with reduced screening in unadjusted (OR 0.891, 95% CI 0.87-0.91, p<0.001) and adjusted analyses (OR 0.897, 95% CI 0.88-0.92, p<0.001). Black participants (OR 0.444, p<0.001) and individuals preferring non-English languages (OR 0.333, p<0.001) had lower screening odds after adjustment. CONCLUSION: Higher neighborhood deprivation is independently associated with lower screening mammography utilization. Targeted, equity-focused interventions addressing neighborhood, racial, and language-related barriers are needed to reduce screening disparities.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.