Journal article
Iowa Spatial Accessibility to Screening Mammography is Improving, but Utilization Among Privately Insured Women Remains Stable, 2016 - 2022
Health & place, Vol.94, 103488
07/2025
DOI: 10.1016/j.healthplace.2025.103488
PMID: 40449344
Abstract
This study explores the spatial accessibility and utilization of mammography screening services in Iowa from 2016 to 2022. Breast cancer continues to be the most incident cancer in Iowa, with early detection through mammography being critical for reducing mortality. Spatial accessibility considers both geographic accessibility and capacity as appointment availability simultaneously. Using optimization models, we evaluated the potential spatial accessibility to mammography screening for women aged 40-84. We found that while access to mammograms improved over time, particularly in rural areas, the theoretical capacity of mammography facilities was insufficient to meet the demand, particularly in suburban and rural areas where driving times posed significant barriers. Additionally, despite improvements in accessibility, utilization rates among privately insured women remained stable, with the highest mammography uptake among urban and suburban women and women of older ages. Discrepancies between the accessibility models and the utilization patterns indicate that additional decisions are being made by patients independent of driving distance, such as appointment availability, provider preference, or wait times, that may influence patients to receive mammograms at farther locations.
•Mammogram facilities theoretical capacity was insufficient to meet potential demand•Mammography utilization was lowest in rural areas and among women aged 40-49•Optimization models captured spatial access but missed utilization nonspatial barriers
Details
- Title: Subtitle
- Iowa Spatial Accessibility to Screening Mammography is Improving, but Utilization Among Privately Insured Women Remains Stable, 2016 - 2022
- Creators
- Caitlyn S. Wiener - University of IowaMargaret Carrel - University of IowaWhitney E. Zahnd - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Health & place, Vol.94, 103488
- DOI
- 10.1016/j.healthplace.2025.103488
- PMID
- 40449344
- NLM abbreviation
- Health Place
- ISSN
- 1353-8292
- eISSN
- 1873-2054
- Publisher
- Elsevier Ltd; London
- Grant note
- Bureau of Radiological Health within the Iowa Department of Health and Human Services
We would like to thank the Bureau of Radiological Health within the Iowa Department of Health and Human Services for their support in making this study possible. We would also like to thank Dr. Sean Young for his guidance with the design and creation of the accessibility model.
- Language
- English
- Electronic publication date
- 05/30/2025
- Date published
- 07/2025
- Academic Unit
- Health Management and Policy; Epidemiology; Geographical and Sustainability Sciences; Internal Medicine
- Record Identifier
- 9984825339402771
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