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Clinical Preventive Service Use Varies Across the United States

THURSDAY, April 1, 2021 -- Use of recommended clinical preventive services varies across the United States, with insurance status being the dominant factor associated with service use, according to research published in the April 2 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Suhang Song, Ph.D., from the CDC in Atlanta, and colleagues analyzed data from the 2018 Behavioral Risk Factor Surveillance System to examine the prevalence of use of 10 recommended clinical preventive services among persons aged 18 years and older.

The researchers found that for colon, cervical, and breast cancer screening, pneumococcal and tetanus vaccination, and diabetes screening, the weighted prevalence ranged from 66.0 to 79.2 percent; the prevalence of the other four services was <50 percent: 16.5, 26.6, 33.2, and 45.8 percent for human papillomavirus vaccination, zoster vaccination, influenza vaccination, and HIV testing, respectively. The widest variation was seen in the prevalence of HIV testing, with 3.1-fold differences across states. There was variation noted in the prevalence of use of clinical preventive services by insurance status, income level, and rurality. The uninsured, those with lower income, and those living in rural communities had lower use of nine of the 10 services examined. The dominant factor associated with the use of clinical preventive services was insurance status, followed by income level and rurality.

"The ongoing monitoring of trends could improve understanding of how modifiable factors affect use of clinical preventive services, especially during the pandemic, because a decrease in use of routine vaccinations was observed," the authors write.

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