BACKGROUND: Mammography screening allows for the early detection of breast cancer, which helps reduce mortality from breast cancer, especially in women aged 50 to 69 years. For this report, the authors updated a previous analysis of trends in mammography using newly available data from the National Health Interview Survey (NHIS). METHODS: NHIS data from 2008 were used to update trends in rates of US women who had a mammogram within the 2 years before their interview, and 2 methods of calculating rates were compared. The authors focused particularly on the 2000, 2005, and 2008 mammography rates for women aged ≥ 40 years, 40 to 49 years, 50 to 64 years, and ≥ 65 years according to selected sociodemographic and healthcare access characteristics. RESULTS: For women aged 50 to 64 years and ≥ 65 years, the patterns were similar: Rates rose rapidly from 1987 to 2000, declined, or were stable and then declined, from 2000 to 2005, and increased from 2005 to 2008. Rates for women aged 40 to 49 years rose rapidly from 1987 to 1992 and were relatively stable through 2008. There were large increases in mammography rates among immigrants who had been in the United States for <10 years, non-Hispanic Asian women, and women aged ≥ 65 years who were without ambulatory care insurance. CONCLUSIONS: Overall, mammography rates did not continue to decline between 2005 and 2008. Even so, in 2008, the percentage of women aged ≥ 40 years who had a recent mammogram fell below the Healthy People 2010 objective of 70%, which was met in 2000. However, women aged 50 to 64 years exceeded the Healthy People objective in 2000, 2005, and 2008; and some groups with very low mammography rates currently are catching up. These are important public health achievements.

OBJECTIVES: Building on Andersen's behavioral model for the utilization of health care services, we examined factors associated with utilization of physician and hospital services among adults in Canada and the United States, with a focus on socioeconomic status (enabling resources in Andersen's framework). METHODS: Using the 2002-2003 Joint Canada/United States Survey of Health, we conducted country-specific multivariate logistic regressions predicting doctor contacts/visits and overnight hospitalizations in the past year, controlling for predisposing characteristics, enabling resources, and several factors representing perceived need for health care. All analyses were appropriately weighted to yield nationally representative results. RESULTS: Several measures of socioeconomic status-having a regular medical doctor, education, and, in the US income and insurance coverage-were associated with doctor contacts or visits in both countries, along with various predisposing and need factors. However, these same measures were not associated with hospitalizations in either country. Instead, only the individual's predisposing characteristics (eg, age and sex) and his/her need for health care predicted utilization of hospital services in Canada and the United States. Insurance coverage status in the United States became a significant predictor of hospitalizations when count data were analyzed via Poisson regression. CONCLUSIONS: Given our particular outcome measures, adults in Canada and the United States exhibited similar patterns of hospital utilization, and socioeconomic status played no explanatory role. However, relative to Canadian adults, we found disparities in doctor contacts among US adults-between those with more income and those with less, between those with health insurance and those without-after adjusting for health care needs and predisposing characteristics.