Capturing Latino Health Disparities: Lessons from Mail- and Community-Based Population Health Surveys in California

Latinos face significant cancer health disparities and remain underrepresented in research. To address regional needs, the University of California Davis Comprehensive Cancer Center (UCDCCC) conducted its first Catchment Area Population Assessment (CAPA) to inform outreach and engagement strategies. Our purpose was to understand the best approaches for capturing Latino health need responses and to understand breast and cervical cancer screening rates and risk factors. This cross-sectional study compared two CAPA survey methodologies used from July 2019 to March 2020: a mail-based approach using random and unweighted probabilistic sampling of residential addresses versus a community-based approach using bilingual coordinators for in-person interviews. Comparisons were made on catchment population representativeness and breast and cervical cancer screening outcomes. The study included 361 Latino participants (255 community based and 106 mail based) across 16 of 19 UCDCCC catchment counties. Mail-based participants were significantly older, more educated, and had higher household incomes than community-based participants. Despite the differences in key demographics of participants in the two survey modalities, our results suggest that up-to-date breast and cervical cancer screening rates do not significantly differ. Time since the last routine checkup, primarily among community-based participants, emerged as a key predictor of screening adherence. Mail-based methods captured more affluent Latinos, whereas community-based methods reached more underserved populations. Each method introduced distinct sampling biases, but together they provided a more balanced representation of the catchment area. Mail- and community-based survey methods enhance the representativeness of Latino health data and support more equitable research recruitment strategies.

Latinos remain underrepresented in cancer research, limiting effective outreach. This study demonstrates that combining mail- and community-based survey methods improves representation across socioeconomic groups, revealing key predictors of breast and cervical cancer screening adherence. These findings inform equitable data collection and engagement strategies, advancing inclusive cancer prevention efforts in underserved populations.