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Background: There are significant racial and ethnic disparities in the delivery of clinical preventive services. A composite measure has been developed to quantify the percentage of men and women age ≥65 who are “up-to-date” with influenza vaccination, pneumococcal vaccination (PPV) and screenings for breast, cervical, and colorectal cancers according to recommended schedules. This level is dependent on the preventive service with the lowest delivery rate. Efforts to reduce disparities in the overall level of preventive service delivery will require interventions that prioritize specific services.
Objectives: To assess the role of adult immunizations in potentially reducing disparities in the composite level of routine preventive service delivery to persons age ≥65.
Methods: Data was analyzed from the 2008 Behavioral Risk Factor Surveillance Survey, which included 121,365 respondents aged ≥65. We created a composite measure that includes influenza vaccination in the past 12 months, PPV ever, mammogram within the past 2 years, Papanicolaou test within 3 years, and colonoscopy/sigmoidoscopy within 10 years or fecal occult blood test in the past 12 months. Separate analyses were performed for men and women who are White, Black, and Hispanic.
Results: For men, the composite measure for Blacks and Hispanics compared to Whites is 28.2% and 27.7% versus 44.7%. The service with the lowest delivery rate among all men is PPV, with rates of 66.4% for whites, 46.6% for Blacks and 46.9% for Hispanics. For women, the composite measure for Blacks and Hispanics compared to Whites is 27.5% and 26.5% versus 36.2%. Among white women, the service with the lowest delivery rate is colon cancer screening at 65.8%, while for Blacks it is influenza vaccination at 54.5% and for Hispanics it is PPV at 52.1%.
Conclusions: Reducing disparities in the composite level of preventive service delivery is dependent on improvements in the provision of adult immunizations.