Underutilization of reproductive health screenings by women living with disabilities in the United States

In the United States, approximately 50.9 million adults under the age of 64 years live with some type of disability. In 2011 approximately 21.8% of men and 28.1% of women under the age of 64 years reported living with a disability, while 53.5% of men and 63.9% of women over the age of 65 years reported living with a disability. Disability is associated with many chronic conditions including obesity, cancer, diabetes, cardiovascular disease (heart disease), hypertension (high blood pressure), asthma, and mental illness. Living with disabilities has been associated with barriers to care and decreased utilization of preventive screenings. Women with disabilities report more issues with receiving reproductive health care when compared to women living without disabilities. Reproductive health screenings for women include clinical breast exams, mammograms, pelvic exams, pap smears, HPV tests, chlamydia tests, and testing for STIs. This problem is relevant to public health because women living with disability are an underserved population in the United States who experience barriers to receiving regular preventive care. In this paper, a literature review was conducted from December 2013 to January 2014. Twenty articles were reviewed to examine the current prevalence of breast cancer and cervical cancer screening behaviors and other preventive screenings for women living with disabilities. The literature review found that women living with disability underutilize breast cancer and cervical cancer screening more than women without disability. Women living with physical disabilities were more likely to be diagnosed with a sexually transmitted infection (STI) than men living with physical disabilities. Women with disabilities experience barriers to care including: environmental, physical, and individual. Women without disabilities reported having better experiences when receiving a mammogram compared to women with disabilities. Women living with multiple disabilities were more likely to need a mammogram machine accessible for persons sitting. Women with an intellectual disability have varying rates of mammogram utilization based on support and living environment. Women with disability who were young, African American, Hispanic, poor or married were more likely to have received a pap smear. In conclusion, women living with disabilities had lower rates of regular screening for both pap tests and mammographies when compared to women without disabilities. Future research is needed to better understand why women with disabilities underutilize preventive screenings. Future research studies should address access to health care issues and barriers to receiving care for women living with disabilities