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American Journal of Epidemiology Advance Access originally published online on March 10, 2007
American Journal of Epidemiology 2007 165(11):1287-1295; doi:10.1093/aje/kwm004
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Perceived Racial Discrimination and Nonadherence to Screening Mammography Guidelines: Results from the Race Differences in the Screening Mammography Process Study

Amy B. Dailey1,2, Stanislav V. Kasl1, Theodore R. Holford1 and Beth A. Jones1

1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT
2 Department of Epidemiology and Biostatistics, University of Florida College of Public Health and Health Professions, Gainesville, FL

Reprint requests to Dr. Amy B. Dailey, Department of Epidemiology and Biostatistics, University of Florida School of Public Health and Health Professions, P.O. Box 100231, Gainesville, FL 32610 (e-mail: abdailey{at}phhp.ufl.edu).

Received for publication December 22, 2005. Accepted for publication November 8, 2006.

The study objective was to determine whether perceived racial discrimination influenced nonadherence to screening mammography guidelines. Enrolled in this prospective study were 1,451 women aged 40–79 years who obtained an "index" screening mammogram at one of five urban hospitals in Connecticut between October 1996 and January 1998. This logistic regression analysis included 1,229 women (484 African American (39%), 745 White (61%)) who completed telephone interviews at baseline and follow-up (on average 29 months later). Perceived racial discrimination was measured as lifetime experience in seven possible situations. Approximately 42% of African-American women and 10% of White women reported lifetime racial discrimination. Perceived racial discrimination was not associated with nonadherence to age-specific mammography screening guidelines in unadjusted or multivariate-adjusted analyses. Although these negative findings may reflect the well-recognized problems associated with measurement of perceived discrimination, it is possible that women who recognize and report racial discrimination develop compensatory characteristics that enable positive health prevention behavior, in spite of their past experiences.

African Americans; breast neoplasms; discrimination (psychology); ethnic groups; mammography; prejudice; risk factors


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