Preventive screenings and vaccinations are critical for reducing morbidity and mortality rates across multiple illnesses and diseases. Yet many U.S. adults still underuse them. The findings from a recent study published in the Journal of Racial and Ethnic Disparities highlight opportunities for providers to strengthen preventive care delivery and better understand barriers affecting different patient populations.
Researchers examined adherence to recommended preventive services among adults aged 35 and older. They sought to address gaps in previous research, which has often grouped diverse populations into broad racial and ethnic categories.
The research team used data from the PREV-CARE (PREVentive Care AdheREnce in Diverse Populations) study, which was a nationally representative online survey conducted in 2023. The survey measured adherence to health screening and vaccination guidelines across major racial and ethnic groups in the U.S.
The study population included 4,111 adults aged 35 and older who identified as American Indian or Alaska Native, Asian, Black, Latino, Middle Eastern or North African, Native Hawaiian or Pacific Islander, white, or multiracial.
The researchers examined the following preventive services:
The researchers adjusted for selected demographic and health-related factors when comparing adherence to preventive care recommendations.
Overall adherence varied by preventive service, ranging from 51 percent for shingles vaccination to 85.5 percent for blood pressure screening. Only 34.4 percent of participants were up to date on all recommended preventive services.
Participants who identified as American Indian or Alaska Native, Middle Eastern or North African, or multiracial had significantly lower adjusted adherence to influenza vaccine guidelines compared with white participants. Multiracial participants also had lower shingles vaccination adherence.
Black participants reported a shingles vaccination adherence rate of 43.6 percent, while multiracial participants reported 29.6 percent. American Indian or Alaska Native adults had the lowest reported pneumococcal vaccination adherence at 56.3 percent, followed by Spanish-speaking Latino adults at 52.9 percent.
Cancer screening patterns also varied across populations. Middle Eastern or North African adults had the lowest reported adherence to breast, cervical, and colorectal cancer screening guidelines among the racial and ethnic groups examined.
Despite the differences across populations, most racial and ethnic groups fell short of Healthy People 2030 targets for cancer screening. No group met the target for influenza vaccination adherence.
The findings suggest that preventive care gaps extend beyond a single medical service or population. For providers, they underscore the importance of reviewing every patient’s screening and vaccination history, identifying overdue services, and discussing recommended care during routine visits.
Barriers to care may also influence adherence. The researchers found that participants with health insurance, higher household incomes, and more advanced education were more likely to use preventive services. Sixty-one-point seven percent of uninsured participants reported adherence to blood pressure screening guidelines, compared with 88.6 percent of those with private insurance.
The researchers noted several limitations. Participants self-reported adherence to preventive care, which may introduce recall or reporting errors. The online PREV-CARE survey may have unintentionally excluded people with limited internet access or digital literacy. Additionally, some subgroup analyses were based on smaller samples, limiting the precision and generalizability of certain estimates.
The researchers didn’t establish why adherence differed. More research is necessary to understand how systemic barriers, health beliefs, communication, and other factors influence preventive care use.
For providers, the findings reinforce the importance of routine preventive care assessments, clear patient communication, and efforts to reduce barriers to recommended care. More detailed data across racial and ethnic populations may help providers and health systems identify where targeted interventions are needed.
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