Psychological Distress is a Barrier to Preventive Care in Women

Madison, Wisconsin — Psychological distress prevents women from obtaining preventive health care, according to a new study led by a researcher at the University of Wisconsin School of Medicine and Public Health.

Whitney P. Witt, PhD, MPH, along with colleagues at University of Cincinnati, Harvard University and Brown University, studied the health care of more than 9,000 women of child-bearing age. The research team looked at the roles of psychological distress, health insurance and having a regular health care provider in determining whether the women received timely routine care.

Women with psychological distress were more likely than nondistressed women to report delaying routine care, being uninsured, and lacking a usual source of care. Among all women reporting a lack of a usual source of care, distressed women were more than six times more likely than non-distressed women to delay seeking a general physical exam for two or more years.

The paper, "Psychological Distress as a Barrier to Preventive Healthcare Among US Women," was published in The Journal of Primary Prevention today.

"Our results suggest that women with psychological distress are less likely to get preventive care — especially if they do not have a usual source of care," said lead author Witt, assistant professor of population health sciences.

Women who lacked health insurance or a regular health care provider were more likely to delay a general physical. Women who were psychologically distressed and also lacked a usual provider were the most likely to report delaying routine care for two or more years. Nearly 60 percent of these women reported delaying care, compared with 45 percent of non-distressed women who did not have a regular provider.

The researchers examined national data on 9,166 women between the ages of 18 and 49. The information was collected in 1998 as part of the National Health Interview Survey (NHIS), a household survey conducted by the National Center for Health Statistics. The study results show that psychological distress may be a significant barrier to women receiving preventive health care.

"Ironically, delays in preventive care limit the ability of health care providers to identify and treat mental health problems in women," Witt says.

Witt says these findings suggest that continuity of care is vital to the health of all women, and especially women with psychological distress, to ensure they receive timely and effective preventive care.

"Ensuring that women, especially psychologically distressed women, have a connection to the health care system is critical to accessing preventive care. If distress is unidentified and untreated, it could impact women's health-promoting behaviors and their long-term health. Future programs and interventions should support the long-term relationships between patients and their providers' clinics. This may be essential to help women access the care they need."