Mobility impairments and use of screening and preventive services

TLDR

Primary care for people with disabilities often focuses on disabling disorders while neglecting preventive care, and factors such as short appointments, inaccessible sites, and inadequate equipment further compromise preventive services. The study examined use of screening and preventive services among adults with mobility problems. Using data from the 1994 National Health Interview Survey and its disability and Healthy People 2000 supplements, multivariable logistic regressions predicted service use based on mobility level, demographics, and health care access. Among 10% of respondents with mobility impairment, those with major difficulties had lower odds of receiving Pap tests (0.6) and mammograms (0.7) and were less likely to receive other preventive services, indicating a need for greater attention to screening and preventive care in this population.

Abstract

OBJECTIVES: Primary care for people with disabilities often concentrates on underlying debilitating disorders to the exclusion of preventive health concerns. This study examined use of screening and preventive services among adults with mobility problems (difficulty walking, climbing stairs, or standing for extended periods). METHODS: The responses of non-institutionalized adults to the 1994 National Health Interview Survey, including the disability and Healthy People 2000 supplements, were analyzed. Multivariable logistic regressions predicted service use on the basis of mobility level, demographic characteristics, and indicators of health care access. RESULTS: Ten percent of the sample reported some mobility impairment; 3% experienced major problems. People with mobility problems were as likely as others to receive pneumonia and influenza immunizations but were less likely to receive other services. Adjusted odds ratios for women with major mobility difficulties were 0.6 (95% confidence interval [CI] = 0.4, 0.9) for the Papanicolaou test and 0.7 (95% CI = 0.5, 0.9) for mammography. CONCLUSIONS: More attention should be paid to screening and preventive services for people with mobility difficulties. Shortened appointment times, physically inaccessible care sites, and inadequate equipment could further compromise preventive care for this population.