Optimizing mobile mammography deployment in Oklahoma 2024: a two-step floating catchment area approach

Area of Science:

• Health Services Research
• Geographic Information Systems
• Public Health

Background:

• Mammography screening is crucial for early breast cancer detection.
• Spatial accessibility to healthcare services can significantly impact health outcomes.
• Previous studies have identified disparities in cancer screening access, particularly in rural settings.

Purpose of the Study:

• To assess spatial accessibility to fixed mammography centers in Oklahoma.
• To identify geographic areas with limited or no access to mammography services.
• To investigate disparities in mammography access stratified by urbanicity and demographic factors.

Main Methods:

• Employed the Two-Step Floating Catchment Area (2SFCA) and Enhanced 2SFCA methods.
• Utilized mammography facility data from the FDA and U.S. Census block group demographics for women aged 40+.
• Analyzed accessibility using 30-minute drive times (2SFCA) and 10, 20, 30-minute distance-decay weighted drive times (E2SFCA), stratified by urban, large rural, and small rural areas.

Main Results:

• 10% of 940,994 eligible women resided in areas with no mammography access.
• Small rural regions exhibited the most significant access barriers.
• Disparities were linked to race and socioeconomic status, with non-Hispanic American Indian/Alaska Native and non-Hispanic White populations disproportionately affected.

Conclusions:

• Significant rural disparities in mammography access persist in Oklahoma.
• Targeted interventions, such as mobile mammography units, are needed to improve access in underserved rural areas.
• Addressing spatial and socioeconomic inequities is essential for enhancing breast cancer screening equity.