Transcript for Vital Signs: Health-Related Social Needs Can Keep Women from Getting Lifesaving Mammograms

Speaker 1-Operator

0:00

Welcome and thank you for standing by. All participants will be able to listen only until the question-and-answer portion of today’s conference. At that time to ask a question, please press star one. Today’s conference is being recorded. If you have any objections, please disconnect at this time. I would now like to turn the conference over to Benjamin Haynes. Thank you, you may begin.

Speaker 2-Benjamin Haynes, Director, CDC Division of Media Relations

0:21

Thank you, Julie. And thank you all for joining us today as we release a new CDC Vital Signs report on women and mammography screening. We’re joined by Dr. Debra Houry, CDC’s Chief Medical Officer and Deputy Director for Program and Science and Dr. Jacqueline Miller, Medical Director for CDC’s National Breast and Cervical Cancer Early Detection Program in the Division of Cancer Prevention and Control and first author of today’s Vital Signs. Today’s briefing is embargoed until 1p.m. Eastern when Vital Signs is live on the CDC website. I will now turn the call over to Dr. Houry.

Speaker: Dr. Debra Houry

0:59

Good afternoon, everyone. And thank you for joining us today. CDC supports the National Cancer Moonshot Initiative to end cancer as we know it. To help get this done, we are bringing our expertise and investments to ensure that everyone can benefit from the tools we have to prevent, detect and treat cancer. More than 40,000 women die from breast cancer each year in the United States. And while death rates from breast cancer have decreased over time, rates remain high in some groups such as black women and women who have low income. routine screening mammograms can help detect breast cancer early when it is easier to treat. And it’s been shown to reduce breast cancer deaths by 22%. Yet in 2022, CDC data show that only about three and four women were up to date with their mammogram as recommended. Today’s CDC Vital Signs report focuses on health-related social needs that can be barriers to getting mammograms that screen for breast cancer. Health-related social needs are adverse social conditions that can be barriers to a person’s health or health care. Examples include food insecurity and lack of access to reliable transportation. These are sometimes called social determinants of health. Women with health-related social needs were less likely to get these lifesaving mammograms to screen for breast cancer. Breast cancer screening varies across the United States and is lowest among women without health insurance, those who have low incomes and those who do not have the usual source of health care. This Vital Signs report shows that experiencing health-related social needs can serve as barriers to receiving health care. Understanding how these health-related social needs can affect women getting screening mammograms, could help improve cancer control efforts and reduce breast cancer deaths. Now I will turn it over to Dr. Jacqueline Miller to highlight the findings of today’s report.

Speaker 4: Dr. Jacqueline Miller

3:06

Thank you Dr. Houry. Today’s Vital Signs highlights that the more health-related right social needs a woman has in her life, the less likely she is to be up to date with getting her mammogram. The U.S. Preventive Task Force recommends that women aged 50 to 74, who are at average risk for breast cancer should get a mammogram every two years to screen for breast cancer. We analyzed data from women ages 40 to 74, who responded to the 2022 Behavioral Risk Factor Surveillance System, to understand the social association between having a mammogram and the social determinants of health and health-related social needs. Social determinants of health and health-related social needs measures were collected as a special module on the social determinants and health equity. Our study found that over 83% of the women aged 50 to 74, who had no health-related social needs had received and received a mammogram in the previous two years as compared to only about 67% with three or more health related needs receiving a mammogram in the previous two years. Our study also showed that there were state level differences in women being up to date with a mammogram. For example, over 85% of the women aged 50 to 74 are up to date with mammograms in Rhode Island, while 64% of women in the same age group reported having a mammogram the past two years in Wyoming. Socio-economic factors also sort of associated differences in women getting mammograms. For example, Black women have the highest rate of being up to date with their mammograms. Use of mammograms increased with increasing income and higher education. The cost of accessing health care was the greatest challenge for some women who did not receive a mammogram in the past two years. Other health related social needs such as being dissatisfied with life, feeling socially isolated, experiencing loss or reduced hours at work, and lacking reliable transportation were all strongly associated with not having a mammogram in the past two years. Women without health insurance, who had low incomes and who did not have a usual source of health care far less likely to get mammograms. The bottom line is women who are more likely to get lifesaving mammograms when their social needs are met. And now our turn it back over to Dr. Houry.

Speaker 3: Dr. Houry

5:35

Thank you, Dr. Miller. All of us have a role to play and helping women address their health-related social needs and making sure that they receive the preventative care that they need. For example, health care providers can do a risk assessment for health-related social needs and refer patients to local social services to receive needed help. Centers for Medicare and Medicaid Services will now reimburse health care providers for these risk assessments. Health care providers can also refer women with low incomes and who are uninsured to a local Breast and Cervical Cancer Early Detection Program for breast and cervical cancer screening services. These programs are investments made by CDC, and are available across the United States through state, tribal and territorial health departments. Community partners can increase the number of organizations that provide services to support social needs such as transportation, food assistance and social integration.

Health departments can work with government and community programs that provide services such as transportation and housing assistance, to make it easier for women to get mammograms. And encourage and support all women in your life at home, work and your community to get mammograms. I get mine regularly. And this past year, one of my close friends was diagnosed with breast cancer on her screening mammogram. And I have no doubt that this early identification and treatment saved her life. Do not put this off. There are services available to help. I will now open it up for questions. Thank you.

Speaker: Operator

7:15

If you would like to ask your question, please press star one. You will be prompted to record your first and last name. Please mute your phone recording your name. And to withdraw your question press star two. Once again to ask a question. Please press star one one.

Our first question comes from Lisa Kalanchoe. With Newsday, your line is open.

 

7:46

Hi, how are you? Thanks

Speaker 4: Reporter

7:47

Thanks for taking my call. Do you have any kind of comparison to previous years it said that you can compare this data back to 2011? Or were these questions not specifically answered in previous surveys? These questions were not answered previously. This is a new module that was introduced in 2022 on the Behavioral Risk Factor Surveillance System. So while there’s a lot of data in that exists from other surveys about this information, this specific data was not available on this specific survey. Okay, thanks so much.

 

8:22

Speaker 1: Operator

8:24

Next question, please. Thank you. Our next question comes from Erin Walsh with Healio, your line is open.

Speaker 5: Reporter

8:30

Hi I was just wondering how my incorporating how might we incorporate unmet needs screening into health care and develop techniques to overcome those barriers that you mentioned in order to improve the number of women who receive mammography screening?

 

8:48

Speaker 3: Dr. Houry

8:49

Hi, this is Dr. Houry.

I’ll start with that. What I would say is, you know, I know that physicians are really busy in their clinical practice. But a lot of this can be done during intake, you know, or on the patient’s questionnaires that are done. And just asking questions around, you know, do they have access to reliable transportation Do they have enough to eat and making sure that when you ask those questions that whether it’s the nurse or the physician, somebody actually looks at those answers, and then discusses it with the patient to make sure they’re linked to services. Asking these questions is critically important. Really just takes a minute to just focus on a couple of key questions and opens that dialogue between a patient and a provider. Thank you. Next question, please.

Speaker 1: Operator

9:32

Thank you. And as a reminder to ask a question, please press star one. Our next question comes from Rachel Lucas with WSLS 10 Roanoke, Roanoke, Virginia. Your line is open.

Speaker 5: Reporter

9:43

Hi, there I was wanting to see if you had any data or can speak on any specific rates in regards to Appalachia or more rural areas. We know that there are some health disparities they are due to lack of access to care

Speaker 4: Dr. miller

10:02

Hi, this is Dr. Miller. We specifically don’t have data from Appalachia. Now the Behavioral Risk Factor Surveillance System is a state-based survey. So those in the areas with Appalachia can look up by maybe metropolitan and non-metropolitan or ZIP code. It depends on what the state has available, but they can break it down on more specific geographic areas to look at specific populations. We do have broad information that we published on metro and non-metro. So it can be broken down, you know, more details in more in the specific states of concern.

10:38

Haynes: Thank you.

Next question, please.

 

10:40

Speaker 1: Operator

10:43

Thank you. Our next question comes from Jessica Glanza with The guardian. Your line is open.

 

10:49

Hello,

Speaker 6: Reporter

10:50

Thank you so much for taking my question. You said that CMS is going to start reimbursing for these risk assessments but also that one of the key drivers of lack of getting a mammogram is lack of health insurance. So could you talk about the what you expect the effect of CMS reimbursing those risk assessments to be if women are already facing barriers, getting health insurance and therefore connecting with CMS?

Speaker 3: Dr. Houry

11:17

This is Dr. Houry. What I would say is, you know, the CMS reimbursement you’re right, it’s great. When you’re in the provider’s office, the provider is able to do that. That’s why CDC though, has these programs through health departments so that, if women go to the health department, even without a physician referral, they can then get access to a screening mammogram. And there’s many different ways that women can access these mammograms. You know, oftentimes you’ll see mobile, you know, mammograms and things like that. So there’s ways to access care outside of the regular health care system. CMS is really for the provider reimbursement to really encourage those conversations and exploration around social determinants.

Speaker 4: Dr. Miller

11:56

And this is Dr. Miller. I’d like to add to that and that it doesn’t have to be just health departments because our programs through the health department’s do contract with providers out into communities. So in your own clinic that’s in your community. If you do not have health insurance, you still might be able to get connected to the program and get your services covered through that program because the program does contract with community health clinics and community physicians

Speaker 6: Reporter

12:22

to those contracts, or is my line still open?

12:25 Haynes

No, you’re fine. Go ahead.

Speaker 6: Reporter

12:26

Thank you so much for letting me ask a follow up to those contracts extend to cancer care if cancer is detected.

Speaker 4

12:35

So the breast and cervical program does not cover cancer care, but the state Medicaid programs there’s a state waiver through CMS, where it is through the Breast Cancer Treatment Act and Medicare can Medicaid can cover cancer care services for people who are diagnosed through the program. Thank you. That’s so helpful. Next question, please. Yes,

Speaker 1: Operator

13:01

thank you. And as a reminder, to ask a question, please press star one. Our next question comes from Joyce with med page today. Your line is open.

Speaker 7: Reporter

13:11

Yeah. Hi, thanks for taking my question. I noticed this study found that black woman women had higher rates of getting mammography, getting their mammograms. Can you talk about why that might be so and whether it’s surprising given that they sometimes have lower rates of getting other types of health care.

Speaker 4

13:39

So this is a report from the individual women, so we can’t say why they’re reporting more mammograms. We have seen this trend over the last few years that the rates of mammograms among black women have been going higher, so it’s not a total surprise. But again, we can’t say exactly why these are self reports that are not verified by medical records or anything in the health care system. So we have to remember that you know, it is what they report. Thank you.

 

14:07 Haynes

Next question, please.

 

Operator: At this time, I’m showing no further questions.

Speaker 2: Haynes

14:15

Okay, if there are no further questions, I’d like to thank Dr. Houry and Dr. Miller for joining us today. And if there are if you do need more information or have follow up questions, please contact the CDC Press Office at 404 639 3286, or you can email media@cdc.gov Thank you.

Speaker 1: Operator

14:37

Thank you for your participation participants. You may disconnect at this time.

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