Objectives. To examine associations between having bone density tests and level of education among white elderly women in managed Medicare. Method. Data from the ninth through twelfth cohort (2006–2009) of the Medicare Health Outcome Survey (HOS) of managed Medicare plans were analyzed; 239331 white elderly women were included. Respondents were grouped by education level and the percentages of respondents who had lifetime bone density testing done among each group were analyzed. Results. 62.7% of respondents with less than a high school education reported previously taking a bone density test. This was lower than the 73.8% for respondents who completed high school and the 81.0% for respondents with more than a high school education. When potential confounding factors such as age, body mass index, marital status, smoking history, year of HOS survey, and region were factored in, the odds ratios of having a bone density test when compared to respondents with less than a high school education were 1.61 and 2.39, respectively, for those with just a high school education and more than a high school education ( ). Conclusion. Higher education was independently associated with greater use of bone density test in these elderly white women. 1. Introduction In recent years, many studies have found a link between education level and the overall health of a person. Lower education was found worldwide to be correlated with increases in many areas of health risk including cardiac dysfunction [1], preterm birth [2], mortality [3], and others diseases [4, 5]. Furthermore, these effects of education disparity on greater disease prevalence [4] and lower life expectancy may be growing [6]. When treating patients with lower education levels, physicians spend less time discussing health related issues [7] which may lead to gaps in health awareness including the use of preventive services. For example, lower levels of education have been linked to lower use of public health services in Brazil [8] and lower use of HIV testing in Portugal’s immigrant population [9]. The goal of this paper is to see if lower education also effects use of bone mineral density test among a group that would benefit most from testing, elderly white women in the United States. Bone fractures can have devastating consequences including pain, loss of mobility function, and death. Among elderly, particularly postmenopausal women, deterioration in bone mass progressively increases the risk of fragility fractures compared to people with healthy bone [10]. While all elderly women in America are at higher
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