Individual well-being and national determinants of screening mammography among women over fifty
Abstract Background Breast cancer is the most prevalent cancer among women worldwide, causing over 400,000 cases of premature death annually. Timely screening mammography (SM) could have prevented most death. Although SM utilization varies across countries, few studies have examined country-level fa...
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2025-01-01
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| Series: | International Journal for Equity in Health |
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| Online Access: | https://doi.org/10.1186/s12939-025-02389-3 |
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| author | Boaz Hovav Shuli Brammli-Greenberg |
| author_facet | Boaz Hovav Shuli Brammli-Greenberg |
| author_sort | Boaz Hovav |
| collection | DOAJ |
| description | Abstract Background Breast cancer is the most prevalent cancer among women worldwide, causing over 400,000 cases of premature death annually. Timely screening mammography (SM) could have prevented most death. Although SM utilization varies across countries, few studies have examined country-level factors, and fewer explored their interaction with individual-level factors. The study aims to analyze individual and country-level variables and their interaction that determines SM utilization and variation between countries. Methods Individual, country, and cross-level models are used to analyze the cross-sectional data from the SHARE database for 26,672 women aged 50 or over, from 27 countries. Key individual variables investigated include quality-of-life (QOL), psychological, and subjective-health status. Country-level variable included government health expenditure (GHE) percentage of GDP, and organized screening programs. Models were adjusted for individual variables such as age and education. Results Self-reported SM utilization varied from 5 to 67% in the countries examined. On the individual level, higher QOL, psychological, and subjective health status positively correlated with SM utilization, as did GHE and organized programs on the country-level. Surprisingly, the interaction between individual and country-level variables shows that while SM utilization positively correlates with higher psychological and subjective health status in high-GHE countries, it negatively correlates in low-GHE countries, and only weakly positive correlates in mid-level GHE countries. Conclusions Better individual well-being, both physical and psychological, increased SM utilization, as did higher GHE and countrywide SM programs. The negative correlations in low-GHE countries and positive correlations in high-GHE countries underscores disparities that need to be addressed. |
| format | Article |
| id | doaj-art-387f03643058467d8348d47c4af163e2 |
| institution | Kabale University |
| issn | 1475-9276 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | International Journal for Equity in Health |
| spelling | doaj-art-387f03643058467d8348d47c4af163e22025-01-26T12:20:40ZengBMCInternational Journal for Equity in Health1475-92762025-01-0124111310.1186/s12939-025-02389-3Individual well-being and national determinants of screening mammography among women over fiftyBoaz Hovav0Shuli Brammli-Greenberg1Faculty of Health Systems Management, The Max Stern Yezreel Valley College Health Systems Management DepartmentThe Hebrew University of Jerusalem, Faculty of MedicineAbstract Background Breast cancer is the most prevalent cancer among women worldwide, causing over 400,000 cases of premature death annually. Timely screening mammography (SM) could have prevented most death. Although SM utilization varies across countries, few studies have examined country-level factors, and fewer explored their interaction with individual-level factors. The study aims to analyze individual and country-level variables and their interaction that determines SM utilization and variation between countries. Methods Individual, country, and cross-level models are used to analyze the cross-sectional data from the SHARE database for 26,672 women aged 50 or over, from 27 countries. Key individual variables investigated include quality-of-life (QOL), psychological, and subjective-health status. Country-level variable included government health expenditure (GHE) percentage of GDP, and organized screening programs. Models were adjusted for individual variables such as age and education. Results Self-reported SM utilization varied from 5 to 67% in the countries examined. On the individual level, higher QOL, psychological, and subjective health status positively correlated with SM utilization, as did GHE and organized programs on the country-level. Surprisingly, the interaction between individual and country-level variables shows that while SM utilization positively correlates with higher psychological and subjective health status in high-GHE countries, it negatively correlates in low-GHE countries, and only weakly positive correlates in mid-level GHE countries. Conclusions Better individual well-being, both physical and psychological, increased SM utilization, as did higher GHE and countrywide SM programs. The negative correlations in low-GHE countries and positive correlations in high-GHE countries underscores disparities that need to be addressed.https://doi.org/10.1186/s12939-025-02389-3Breast cancerDepressionHealth expenditureMultilevel analysisQuality of lifeScreening mammography |
| spellingShingle | Boaz Hovav Shuli Brammli-Greenberg Individual well-being and national determinants of screening mammography among women over fifty International Journal for Equity in Health Breast cancer Depression Health expenditure Multilevel analysis Quality of life Screening mammography |
| title | Individual well-being and national determinants of screening mammography among women over fifty |
| title_full | Individual well-being and national determinants of screening mammography among women over fifty |
| title_fullStr | Individual well-being and national determinants of screening mammography among women over fifty |
| title_full_unstemmed | Individual well-being and national determinants of screening mammography among women over fifty |
| title_short | Individual well-being and national determinants of screening mammography among women over fifty |
| title_sort | individual well being and national determinants of screening mammography among women over fifty |
| topic | Breast cancer Depression Health expenditure Multilevel analysis Quality of life Screening mammography |
| url | https://doi.org/10.1186/s12939-025-02389-3 |
| work_keys_str_mv | AT boazhovav individualwellbeingandnationaldeterminantsofscreeningmammographyamongwomenoverfifty AT shulibrammligreenberg individualwellbeingandnationaldeterminantsofscreeningmammographyamongwomenoverfifty |