Objective:

To assess the relationship between perceived individual and neighborhood health determinants and rates of mammography screening among women aged 40-74, highlighting the significance of addressing health disparities.

Key Findings:

• 52% of participants had at least one mammogram during follow-up.
• Women with high perceived stress and discrimination had lower screening rates (IRR = 0.84 [95% CI, 0.79-0.90] and IRR = 0.92 [95% CI, 0.88-0.95], respectively).
• Perceived neighborhood physical disorder and social cohesion did not significantly impact screening rates.
• The associations did not differ by race and ethnicity.

Interpretation:

High levels of perceived stress and discrimination are linked to lower rates of breast cancer screening, indicating that these factors create additional barriers for women in accessing necessary healthcare, with implications for policy and practice.

Limitations:

• The study relies on self-reported data, which may introduce bias, particularly in the context of perceived stress and discrimination.
• The cross-sectional nature of the data limits causal inferences.

Conclusion:

Addressing perceived stress and discrimination may improve breast cancer screening rates, particularly among marginalized groups, emphasizing the need for targeted interventions in healthcare settings.