Spatial Accessibility to Mammography Services in the Lower Mississippi Delta Region States

Abstract

Purpose To characterize spatial access to mammography services across 8 Lower Mississippi Delta Region (LMDR) states. These states include the Delta Region, a federally designated, largely rural, and impoverished region with a high proportion of black residents and low mammography utilization rates. Methods Using the enhanced 2‐step floating catchment area method, we calculated spatial accessibility scores for mammography services across LMDR census tracts. We compared accessibility scores between the Delta and non‐Delta Regions of the LMDR. We also performed hotspot analysis and constructed spatial lag models to detect clusters of low spatial access and to identify sociodemographic factors associated with access, respectively. We obtained mammography facility locations data from the Food and Drug Administration and sociodemographic variables from the American Community Survey and the US Department of Agriculture. Results Overall, there were no differences in spatial accessibility scores between the Delta and non‐Delta Regions, though there was some state‐to‐state variation. Clusters of low spatial access were found in parts of the Arkansas, Mississippi, and Tennessee Delta. Spatial lag models found that poverty was associated with greater spatial access to mammography. Conclusions The lack of identified differences in spatial access to mammography in the Delta and non‐Delta Regions suggests that psychosocial or financial barriers play a larger role in lower mammography utilization rates. Identifying clusters of low spatial access to mammography services can help inform resource allocation. Further, our study underscores the value of using coverage‐based methods rather than travel time or container measures to evaluate spatial access to care.

Spatial accessibility to colonoscopy and its role in predicting late‐stage colorectal cancer

“…5,[7][8][9] In keeping with previous studies that employed 2SFCA method, we characterized "supply" as the location and/or number of providers or screening equipment (eg, mammography machines) at a given location. [11][12][13][14][15][16][17][18] However, these methods could be enhanced by considering more nuanced characterizations of supply of colonoscopy services. For example, studies suggest that volume of procedures may be more meaningful than number of providers to characterize access and may be more strongly associated with CRC outcomes compared to provider-based measures.…”

“…Our goal was to apply 2SFCA methods to colonoscopy access, which has not been examined in previous studies that have only examined travel time to colonoscopy providers without accounting for supply and demand 5,7‐9 . In keeping with previous studies that employed 2SFCA method, we characterized “supply” as the location and/or number of providers or screening equipment (eg, mammography machines) at a given location 11‐18 . However, these methods could be enhanced by considering more nuanced characterizations of supply of colonoscopy services.…”

“…The 2SFCA method has been frequently used to examine spatial access to primary care and breast cancer screening services, but have been underutilized in the examination of access to colonoscopy services. [12][13][14][15] As its name indicates, the classic 2SFCA method is performed in two steps. The first step determines a provider-to-population ratio within a provider catchment area, while the second step sums the provider-population ratios of providers within an area's catchment to calculate a score.…”

Mapping mammography in Arkansas: Locating areas with poor spatial access to breast cancer screening using optimization models and geographic information systems

“…Since that time the population in Arkansas has increased by 20% from 2.5 million to over 3 million people, and the number of FDA-certified mammography facilities in Arkansas has decreased by 38%, exacerbating disparities in spatial access, particularly for rural women. In fact, a recent study found Arkansas had the lowest spatial accessibility to mammography facilities of all states in the Lower Mississippi Delta Region [26].…”

The accessibility analysis of multiple public facilities in the central urban areas based on multi‐transportation modes: A study in Chengdu

“…The purpose is to add impedance to the model. E2SFCA divides the time threshold into several intervals and weights each interval (Kar et al., 2021; Zahnd et al., 2019). There are some subjective components in delineating intervals and determining weights (Jin & Lu, 2023).…”