Exploring the Relationship between Social Engagement Activities and Mammography Screening Among Older Non-Hispanic White, African American, and Hispanic Women

Background and Purpose: Breast cancer is the second leading cause of death among older women. Furthermore, minority women have higher breast cancer mortality rates compared to non-Hispanic White (NHW) women possibly due to lower participation in mammography screening. Empirical evidence consistently indicates that mammography screening behaviors are influenced by psychosocial factors, such as attitudes, knowledge, values and beliefs with little attention to the role of social engagement and mammography screening. Social engagement is participation in formal and informal activities and social groups. This investigation explored the relationship between social engagement factors and mammography screening among older Hispanic, African American, and NHW women.

Methods: Guided by the social ecological model, this investigation examined the relationship between social engagement factors (going to a sports or social clubs, reading books or newspapers, baking or cooking something special, playing a sport or exercising) and participation in mammography screening. To be included in the sample, participants 1) responded to breast cancer screening question and 2) responded to all 19 social engagement factors. Data from the 2008 and 2012 waves of the Health and Retirement study were used. Mixed effects logistic regression models were used to estimate the effect of social engagement factors on mammography screening and changes in participation in mammography screening, after adjusting for socioeconomic factors and patient health status over time.

Results: Findings indicate that 8,003 (67%) women received a mammogram in 2012. For every one point increase towards daily volunteering or charity work in 2008, Hispanics were more likely (OR=2.1) to participate in breast cancer screening in 2012. For every one point increase towards daily baking or cooking something special, Hispanics were more likely (OR=2.0) to participate in breast cancer screening in 2012. For every one point increase towards daily praying in private places, NHWs were more likely (OR=1.1) to participate in breast cancer screening in 2012. For every one point increase towards daily walking for 20 minutes or more, NHWs were less likely (OR=.91) to participate in breast cancer screening in 2012. For every one point increase towards daily use of a computer for e-mail Internet or other tasks in 2008, African Americans were less likely (OR=.87) to participate in breast cancer screening in 2012. Furthermore, for every one point increase towards daily playing of sports or exercise, African Americans were less likely (OR=.82) to participate in breast cancer screening in 2012.

Conclusions and Implications: Social engagement factors are potential contributors to increased mammography screening among older minority women. While social engagement factors did not lead to increased screening among African Americans, volunteering and baking or cooking had a positive impact on Hispanics’ mammography screening participation. Utilizing these findings, social workers can help Hispanics engage in similar activities to improve cancer screening rates by assessing for this information and encouraging Hispanics to participate in social engagement activities. However, social workers need to continue to explore other factors that influence mammography screening among African American women so that the health of all women, regardless of racial or ethnic identity is improved.