ACS Research Highlights

Housing Help May Help Some Women Get Mammograms 

ACS researchers find some women with low income are more likely to get breast cancer screening when they get housing assistance than ones who don’t.

The Challenge

Which of these situations makes it difficult for a person to get breast cancer screening and go to any necessary follow-up visits?

  1. Not having health insurance that covers the cost of cancer screenings
  2. Having insecure housing—not having a permanent address
  3. Not having paid time off to go to cancer screening appointments
  4. Living far away from facilities that give cancer screenings
  5. Earning very little money—less than the national poverty line
  6. All of the above

Most people in the United States would ace this quiz (The answer is 6. All of the above.) without any preparatory information or statistics.

The challenge is each of these issues is complicated to solve.

The government has made large strides toward health equity with the passage of the Affordable Care Act (ACA). It significantly increases health insurance coverage. However, socioeconomic disparities in cancer screening have persisted despite the ACA, and more work is needed to raise cancer screening rates.

Another helpful government program is the US Dept of Housing and Urban Development (HUD), which subsidizes the cost of housing for renters with low incomes. The question is whether programs like housing assistance increase screening for people facing financial challenges and barriers to care like the ones above.

The Research

The American Cancer Society’s Cancer Disparity Research team recently published a study in the American Journal of Preventive Medicine describing their analysis of housing assistance programs and the use of cancer screening. They evaluated the use of screening exams for breast cancer, cervical cancer, and colorectal cancer between renters with low income who did and who didn’t have government housing assistance.

They found that housing assistance was associated with increased breast cancer screening for these specific groups of women:

  • Hispanic women
  • Women between the ages of 45 and 54
  • Women who live in urban settings

The researchers did not find a link between housing assistance and screening for cervical cancer or colorectal cancer.

Both Hispanic women and women ages 45 to 54 with housing assistance were twice as likely to be up to date with ACS mammogram guidelines than women in either of those groups who didn’t have housing assistance.

We weren’t too surprised by these findings. Making housing more affordable is not enough to sufficiently eliminate all the socioeconomic disparities that affect cancer screening.”

Jordan Baeker Bispo, PhD, MPH

Principal Scientist, Cancer Disparities Research

Surveillance Health Science & Health Equity, American Cancer Society

In addition to Jordan Baeker Bispo, PhD, MPH, lead author of the study, other ACS researchers involved in the study are Hyunjung Lee, PhD, MS, MPP, MBA,Parichoy Pal Choudhury, PhD,Ahmedin Jemal, DVM, PhD, and Farhad Islami, MD, PhD.

Why It Matters

Cancer screening rates are low for adults with limited income. This study found that housing assistance programs might improve the accessibility of preventive care services like cancer screening for certain low-income groups, especially younger women who are due for mammogram.

However, reducing the rent burden alone does not directly address the many other causes of financial strain that can create barriers to keeping up with cancer screening guidelines.

Housing assistance might be one method that successfully increases the ability of certain groups of women to go get a cancer screening, which can save lives. But it doesn’t address other obstacles like the cost of food, transportation, and other expenses.

“More than one situation contributes to disparities in cancer screening,” Baeker Bispo says, “and it will likely take a combination of strategies – like increasing the accessibility providers and improving health literacy - to resolve them. Using data to analyze the effect of existing programs may help us find the most helpful combination of programs for different subgroups  more efficiently.”