Contrasting Breast Cancer Screening Patterns Among Mexican Immigrant Women in Rural Vs. Urban U.S

Background and Purpose: Breast cancer remains a critical public health issue in the United States, with Latina women experiencing marked disparities in incidence and mortality rates. This study focuses on Mexican immigrant women in Illinois, highlighting differences in breast cancer screening behaviors between rural and urban populations. Researching rural areas is crucial as these regions typically face greater barriers to healthcare access, including fewer local healthcare facilities, longer travel distances for treatment, and limited availability of culturally sensitive medical personnel. Additionally, rural women may adhere more strongly to traditional cultural beliefs that can further impede screening practices. The study aims to identify and analyze the key barriers and facilitators that influence mammography uptake among these women, emphasizing how geographic and cultural contexts shape their health-seeking behaviors.

Methods: This comparative study employed a mixed-methods design, enrolling 321 Mexican immigrant women aged 40 and above from rural (populations <2,000) and urban settings in Illinois who had not been previously diagnosed with cancer. Sampling was conducted using targeted and snowball techniques to ensure a diverse participant pool reflective of the demographic and socioeconomic status of the study population. Data collection involved structured household interviews and surveys administered in both English and Spanish, with questions designed to capture cultural beliefs, screening behaviors, and perceived barriers to healthcare. Statistical analysis utilized t-tests to compare continuous variables and chi-square tests for categorical variables, with significance evaluated at p<0.05.

Results: The study revealed statistically significant differences between rural and urban participants in terms of cultural beliefs and screening practices. Rural women reported higher adherence to spiritualismo (M=4.31, SD=1.13; p<0.01), marianismo (M=3.33, SD=0.45; p<0.05), and machismo (M=3.02, SD=0.52; p<0.01). Additionally, 54.4% of rural participants had undergone mammography compared to 45.6% in urban areas (p<0.05). Barriers such as lack of doctor recommendation and cultural discomfort with medical procedures were more pronounced in rural areas.

Conclusions and Implications: This study highlights significant disparities in breast cancer screening between rural and urban Mexican immigrant women in Illinois, emphasizing the influence of cultural beliefs and accessibility on health behaviors. In rural areas, stronger adherence to cultural norms such as spiritualismo, marianismo, and machismo correlates with lower mammography rates, pointing to the need for culturally and linguistically tailored healthcare interventions. Addressing these disparities requires policies that enhance service availability in rural settings through mobile mammography units and bilingual healthcare staff. Social workers play a critical role in bridging cultural gaps by leveraging local networks for community-based education that promotes health literacy and screening uptake. Future research should focus on the long-term effectiveness of these interventions and the impact of policy changes like Medicaid expansion on screening behaviors, guiding efforts to equalize healthcare access and outcomes for these underserved populations.