Preventive behavior among recent immigrants: Russian-speaking women and cancer screening in Israel

This study examined the risk profile and preventive practices aimed at female reproductive cancer in a national sample of 620 women aged over 35, who immigrated to Israel from the former Soviet Union after 1989. The study setting typifies a more general problem of the encounter between East European immigrants and western-type health cultures and medical systems. It has shown that universal access to preventive care may not translate into its optimal utilization among marginalized population groups. Specifically, while being at moderate to high cancer risk, Russian immigrants avoid screening activities; gynecological check-ups, breast examination and mammography. This is a reversal of the pre-emigration pattern: two thirds of respondents underwent cancer screening in their home country and only one third in Israel. The risk groups for late detection of cancer are the women least integrated into the mainstream society: those over 60, unemployed or having unskilled jobs. Women without regular primary care providers showed the lowest cancer awareness and minimal screening activity. Even those who knew the key cancer facts, believed in their own susceptibility and in the benefit of early detection, in practice did little to avert the danger. Three explanations for the discrepancy between cognition and practice are suggested: (a) the immigrants' low health motivation, reflecting their downward social mobility and preoccupation with resettlement problems; (b) low self-efficacy and external locus of control over health, typical of ex-Soviet citizens and (c) communicative and other cultural barriers to health care services.