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Determinants of Mammography Usage across Rural and Urban Regions of Canada


  • James Ted McDonald
  • Angela Sherman


Breast cancer is a leading source of mortality among Canadian women; however early detection via mammography considerably improves survival rates. Accordingly, national guidelines advocate biennial screening for asymptomatic women aged 50 to 69 years. Unfortunately many women do not abide by such recommendations, and there is some evidence that compliance rates are lower in rural areas. This report explores the extent of regional variation within and between Canadian provinces using a new and more detailed set of rural indicators based on economic zones of influence. We find the incidence of ever having a mammogram and screening within the last two years are significantly lower for women most removed from large urban centers. This result is obtained after controlling for demographic and socio-economic characteristics, concentration of physicians and specialists in the local area and whether the woman has a regular family doctor. An important reason for the observed differences across rural and urban areas is found to be awareness of the need for regular screening. We also observe that differences in mammography usage between rural and urban areas vary significantly across Canadian provinces.

Suggested Citation

  • James Ted McDonald & Angela Sherman, 2008. "Determinants of Mammography Usage across Rural and Urban Regions of Canada," Social and Economic Dimensions of an Aging Population Research Papers 238, McMaster University.
  • Handle: RePEc:mcm:sedapp:238

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    References listed on IDEAS

    1. Wilson, Kathi & Rosenberg, Mark W., 2004. "Accessibility and the Canadian health care system: squaring perceptions and realities," Health Policy, Elsevier, vol. 67(2), pages 137-148, February.
    2. Cloutier-Fisher, Denise & Joseph, Alun E., 2000. "Long-term care restructuring in rural Ontario: retrieving community service user and provider narratives," Social Science & Medicine, Elsevier, vol. 50(7-8), pages 1037-1045, April.
    3. Vernon, Sally W. & Laville, Elizabeth A. & Jackson, Gilchrist L., 1990. "Participation in breast screening programs: A review," Social Science & Medicine, Elsevier, vol. 30(10), pages 1107-1118, January.
    4. Heather Conde & James Ted McDonald, 2007. "The Health Services Use Among Older Canadians in Rural and Urban Areas," Social and Economic Dimensions of an Aging Population Research Papers 178, McMaster University.
    5. Bottorff, Joan L. & Johnson, Joy L. & Bhagat, Radhika & Grewal, Sukhdev & Balneaves, Lynda G. & Clarke, Heather & Hilton, B. Ann, 1998. "Beliefs related to breast health practices: the perceptions of South Asian women living in Canada," Social Science & Medicine, Elsevier, vol. 47(12), pages 2075-2085, December.
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    Cited by:

    1. Corallo, Ashley N. & Croxford, Ruth & Goodman, David C. & Bryan, Elisabeth L. & Srivastava, Divya & Stukel, Therese A., 2014. "A systematic review of medical practice variation in OECD countries," Health Policy, Elsevier, vol. 114(1), pages 5-14.

    More about this item


    mammography; cancer screening; rural health; women's health;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • R23 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Regional Migration; Regional Labor Markets; Population

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