Date of Conferral

2020

Degree

Ph.D.

School

Public Health

Advisor

Sriya Krishnamoorthy

Abstract

AbstractDespite many national interventions, cervical cancer (CC) rates persist, and in Kentucky (KY), CC incidence rates are on the rise. Additionally, women with disabilities face more barriers to secondary prevention and healthcare access, have more known risks, and experience more health disparities than women without disabilities. Given that 1 in 4 persons live with a disability, the purpose of this observational, cross-sectional, quantitative study was to explore the relationship between CC and women with disabilities as evidenced by reproductive cancer discharges from inpatient hospital (IHD) and outpatient services databases (OSD) so as to compare population-specific differences from social determinants of health framework. Data from the Kentucky Cabinet for Health and Family Services for 2015 to 2018 were analyzed using MLR. In total, the sample included 584 women with disabilities and 32,773 women without disabilities living in KY. Results of the IHD data analysis found that county of residence (p =.014) and insurance payer (p = .000) were statistically significant and that women on Medicaid were 9.6 times as likely to be diagnosed with CC. Results of the OSD data analysis found that county (p = .000) and age group (p = .000) were statistically significant and that women aged 40-44 were 9.5 and 2.9 times as likely to have breast cancer and CC respectively. This study’s findings call for greater attention to the determinants that affect health factors among women in KY, to the visibility of people with disabilities in the data, and to tailored interventions that ensure increased access to value-based health services for women in KY thereby decreasing health disparities, especially for women with disabilities.

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