Abstract A097: Assessing patterns of cancer screening uptake, healthcare access, health status, and the county-level Social Vulnerability Index in Louisiana
Authors: Pereira Malesa , Elewonibi Bilikisu 
Published: December 2023

Abstract
Background The Social Vulnerability Index (SVI) was originally developed to identify areas of high need prior to a disaster but it can also be used to identify medical underserved communities and areas of shortages of medical care. There are four major themes that contribute to SVI: 1) socioeconomic status, 2) household characteristics, 3) racial and ethnic minority status, and 4) housing type/transportation which can be used to examine cancer screening uptake in communities as their socioeconomic makeup contributes to the ability of individuals to access cancer screening. Cancer screenings are essential and highly effective tools when diagnosing cancer early which significantly improves chances of cancer survival and decreases chances of morbidity. This study aims to examine the association of county-level cancer screening uptake and SVI patterns in Louisiana while adjusting for healthcare utilization and self-reported health status. Methods 2020 county level age-adjusted cancer screening rates for breast, cervical, and colorectal, healthcare utilization rates, and health status rates for Louisiana were obtained from CDC’s PLACES website and SVI were obtained from CDC ATSDR. The county-level SVI was recoded into four categories: very low (0-.2499), low (0.2500-0.4999), high (0.5000-0.7499), and very high (0.7500-1.000) with high SVI implying least amount of resources. Linear regressions were used to assess the associations between screening rates and SVI quartiles while adjusting for healthcare utilization and health status variables. Results Of the 64 counties in Louisiana, the mean for county-level cancer screening rate were 1) breast cancer at 74.93% (range, 70.40%-79.90%), 2) colorectal cancer at 68.60% (range, 62.60%-75.10%), and cervical cancer at 81.57% (range, 77.4%-85.60%). The multivariable regression models showed very high SVI was associated with low cancer screening rates. When comparing very high SVI and very low SVI, the unadjusted odds ratio (OR) for cervical cancer screening, 0.25 (95% CI, 0.11-0.54) and colorectal cancer screening, 0.59 (95% CI, 0.18-0.59) showed significance. After adjusting for healthcare utilization and health status among very high SVI and very low SVI, all three breast, cervical, and colorectal cancer screening showed statistically significant associations. For uninsured rates, unadj. OR for breast, 8.95 (95% CI, 3.32-24.18) cervical, 5.16 (95% CI, 1.90-14.05) and colorectal, 7.12 (95% CI, 2.44-20.76) showed significance. For general health status, unadj. OR for breast, 9.42 (95% CI, 3.60 - 24.63) cervical, 6.64 (95% CI, 2.68 - 16.44) and colorectal, 9.94 (95% CI, 3.46 - 28.58) showed significance. Conclusions This study found that areas with very high SVI had low rates of cancer screening rates, low healthcare utilization, and high levels of self-reported fair/poor general, mental, and physical health status. These areas may benefit from community level interventions to address barriers to care and better dialogues of the importance of keeping up with routine checkup including cancer screenings.
Citation Format: Malesa Pereira, Bilikisu Elewonibi. Assessing patterns of cancer screening uptake, healthcare access, health status, and the county-level Social Vulnerability Index in Louisiana [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A097.