TY - JOUR
T1 - Medicaid coverage expansion and implications for cancer disparities
AU - Choi, Seul Ki
AU - Adams, Swann Arp
AU - Eberth, Jan M.
AU - Brandt, Heather M.
AU - Friedman, Daniela B.
AU - Tucker-Seeley, Reginald D.
AU - Yip, Mei Po
AU - Hébert, James R.
PY - 2015/11
Y1 - 2015/11
N2 - Objectives: We estimated the impact on cancer disparities in US states that have chosen or not chosen to expand Medicaid since passage of the Patient Protection and Affordable Care Act. Methods: Data came from the 2013 Uniform Data System for colorectal and cervical cancer screening rates among patients of federally qualified health centers (FQHCs); the 2012 Behavioral Risk Factor Surveillance System for colorectal, cervical, and breast cancer screening rates; and the US Cancer Statistics (2007-2011) for colorectal, cervical, and breast cancer mortality-toincidence ratios (MIRs). Dyads of Medicaid expansion decisions with cancer screening rates and MIRs were mapped using ArcMap. Results: States that had not expanded Medicaid as of September 2014 had lower cancer screening rates, especially among FQHC patients. Overall, cancer MIRs were not significantly different by Medicaid expansion status. However, Southeastern states without Medicaid expansion tended to have higher cancer MIRs and lower screening rates. Conclusions: Disparities in cancer screening that already disfavor states with high cancer rates may widen in states that have not chosen to expand Medicaid unless significant efforts are mounted to ensure their residents obtain preventive health care.
AB - Objectives: We estimated the impact on cancer disparities in US states that have chosen or not chosen to expand Medicaid since passage of the Patient Protection and Affordable Care Act. Methods: Data came from the 2013 Uniform Data System for colorectal and cervical cancer screening rates among patients of federally qualified health centers (FQHCs); the 2012 Behavioral Risk Factor Surveillance System for colorectal, cervical, and breast cancer screening rates; and the US Cancer Statistics (2007-2011) for colorectal, cervical, and breast cancer mortality-toincidence ratios (MIRs). Dyads of Medicaid expansion decisions with cancer screening rates and MIRs were mapped using ArcMap. Results: States that had not expanded Medicaid as of September 2014 had lower cancer screening rates, especially among FQHC patients. Overall, cancer MIRs were not significantly different by Medicaid expansion status. However, Southeastern states without Medicaid expansion tended to have higher cancer MIRs and lower screening rates. Conclusions: Disparities in cancer screening that already disfavor states with high cancer rates may widen in states that have not chosen to expand Medicaid unless significant efforts are mounted to ensure their residents obtain preventive health care.
UR - http://www.scopus.com/inward/record.url?scp=84946729267&partnerID=8YFLogxK
U2 - 10.2105/AJPH.2015.302876
DO - 10.2105/AJPH.2015.302876
M3 - Article
C2 - 26447909
AN - SCOPUS:84946729267
SN - 0090-0036
VL - 105
SP - S706-S712
JO - American Journal of Public Health
JF - American Journal of Public Health
ER -