Disparities in Vaccinations and Cancer Screening Among U.S.- and Foreign-Born Arab and European American Non-Hispanic White Women

Background: Disparities in vaccinations and cancer screening exist when comparing foreign-born and U.S.-born women collectively and disaggregated by race and ethnicity. The purpose of this study was to estimate and compare the age-adjusted prevalence of not receiving a flu or pneumonia vaccine, clinical breast examination, mammogram or Pap smear among U.S.- and foreign-born White women by region of birth and examine associations while controlling for potential confounders. Methods: We pooled 12years of National Health Interview Survey data (n=117,893). To approximate an "Arab-American" ethnicity, we identified 15 "Arab" countries from the Middle East region that comprise the Arab Nations. Data was requested from the National Center for Health Statistics Research Data Center. We used the χ² statistic to compare descriptive statistics and odds ratios (ORs) with 95% CIs were used for inferential statistics. Findings: Compared to U.S.-born, foreign-born Whites from the Arab Nations had higher estimates of not receiving recommended vaccinations and cancer screenings. In crude and adjusted analyses, foreign-born Arab-American women were less likely to report receiving a flu vaccine (OR,0.34; 95% CI,0.21-0.58), pneumonia vaccine (OR,0.14; 95% CI,0.06-0.32), Pap smear (OR,0.13; 95% CI,0.05-0.31), or clinical breast examination (OR,0.16; 95% CI,0.07-0.37) compared with U.S.-born White women. There were no differences for mammography. Conclusions: This national study examining uptake of flu and pneumonia vaccines and preventive cancer screenings suggests that estimates are lower for foreign-born Arab-American women compared with U.S.-born White women. Future studies should collect qualitative data that assess the cultural context surrounding prevention and screening behaviors among Arab-American women.