Women, work, and preventive health care: an exploratory study of the efficacy of HMO membership

Abstract

This study's purpose is to explore the possibility of competing roles (paid employment and childcare responsibilities) impinging upon women's annual Pap, breast and blood pressure screenings, and whether HMO enrollments further preventive health care for women in different situations. Using data from the National Access to Medical Care Survey of 1982, the sample includes 594 women who are HMO patients, and 2765 women having regular sources of care from providers in other settings. The findings indicate a strong association between women's relative financial responsibilities for their families and their use of preventive health services. Women who live in traditional situations (no employment outside the home, supported by a male) and women who share the financial burden with men (the "new" multiple-earner families) have substantially more Pap and breast examinations, respectively, than non-traditional family women who carry the full burden themselves. However, these latter women were more likely to have had blood pressure screening--the least expensive, most convenient procedure of those studied. Overall, HMOs did not increase preventive care for traditional family women, did help in marginally boosting the breast examinations of women who share financial responsibility with men, and in the blood pressure screenings for women in nontraditional families. The conclusions stress the importance of measures of women's employment in examining access to care, and call for closer scrutiny of HMOs' preventive care protocols for particularly vulnerable clients.