Disparities in Cholesterol Screening: Falling Short of a National Health Objective

Background. The objective of this study was to determine whether the Year 2000 national health objective for cholesterol screening was attained and to identify disparities in cholesterol screening across racial or ethnic and socioeconomic groups. Methods. Using data from 149,692 persons interviewed by the 1999 Behavioral Risk Factor Surveillance System, we estimated the proportion of adults age ≥20 years who were screened for high blood cholesterol within the preceding 5 years. Results. Overall, an estimated 70.8% of the U.S. population was screened for cholesterol, falling short of the Year 2000 objective of 75%. Screening prevalence was lowest at ages 20–44 years (58.2%), in contrast to ages 45–64 years (81.9%) and ≥65 years (87.1%). Screening prevalence was also low among Asian or Pacific Islanders (62.7%) and Hispanics (60.7%), particularly Hispanic men (55.3%). After multivariate adjustment, Asian Pacific Islanders were significantly less likely to be screened compared with white non-Hispanics (OR = 0.76, 95% CI 0.65, 0.89). The likelihood of screening decreased with decreasing income level (P < 0.05) and persons with health insurance were 1.6 times more likely to have been screened during the past 5 years than adults with no insurance (P < 0.05). Conclusions. Significant disparities in cholesterol screening exist across age, gender, racial or ethnic, and socioeconomic groups in the United States. As we look to attain the objectives of Healthy People 2010, state and local health officials and policy makers should be aware of these disparities in order to design and target effective cholesterol screening programs and cardiovascular disease prevention programs to those most in need.