Interview Language: A Proxy Measure for Acculturation Among Asian Americans in a Population-Based Survey

We examined health status and access to care among Asian Americans by the following acculturation indicators: nativity, percent lifetime in the US, self-rated English proficiency, and interview language, to assess whether any measure better distinguishes acculturation. Data from the 2003 California Health Interview Survey were used to study the sample of 4,170 US-born and foreign-born Asians by acculturation indicators. We performed t-tests to compare differences in demographics, health status and behaviors, and access to care between the foreign-born and US-born Asians, and between various classifications within foreign-born and the US-born Asian group. Our results showed that foreign-born Asians who interviewed in English more closely resembled US-born Asians than foreign-born Asians who interviewed in languages other than English. Compared to interview language, dichotomizing the sample by other acculturation indicators showed smaller differences between the divided groups. Interview language may serve as a better measure for acculturation especially among foreign-born populations with a high proportion of limited English proficiency. In immigrant public health research studies, interview language may be used as an important covariate for health disparities

Heavy hadron spectroscopy and the bag model

Some time ago a slightly improved variant of bag model (the modified bag model) suitable for the unified description of light and heavy hadrons was developed. The main goal of the present work was to calculate the masses of the ground state baryons containing bottom quarks in the framework of this model. For completeness the predictions for other heavy hadrons are also given. The reasonable agreement of our results with other theoretical calculations and available experimental data suggests that our predictions could serve as a useful complementary tool for the interpretation of heavy hadron spectra.Comment: 18 pages, 9 tables, references to experiments updated, rms deviations given in some table

The effects of socioeconomic status and indices of physical environment on reduced birth weight and preterm births in Eastern Massachusetts

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Air pollution and social characteristics have been shown to affect indicators of health. While use of spatial methods to estimate exposure to air pollution has increased the power to detect effects, questions have been raised about potential for confounding by social factors.Methods: A study of singleton births in Eastern Massachusetts was conducted between 1996 and 2002 to examine the association between indicators of traffic, land use, individual and area-based socioeconomic measures (SEM), and birth outcomes ( birth weight, small for gestational age and preterm births), in a two-level hierarchical model.Results: We found effects of both individual ( education, race, prenatal care index) and area-based ( median household income) SEM with all birth outcomes. The associations for traffic and land use variables were mainly seen with birth weight, with an exception for an effect of cumulative traffic density on small for gestational age. Race/ethnicity of mother was an important predictor of birth outcomes and a strong confounder for both area-based SEM and indices of physical environment. The effects of traffic and land use differed by level of education and median household income.Conclusion: Overall, the findings of the study suggested greater likelihood of reduced birth weight and preterm births among the more socially disadvantaged, and a greater risk of reduced birth weight associated with traffic exposures. Results revealed the importance of controlling simultaneously for SEM and environmental exposures as the way to better understand determinants of health.This work is supported by the Harvard Environmental Protection Agency (EPA) Center, Grants R827353 and R-832416, and National Institute for Environmental Health Science (NIEHS) ES-0002

Chance and necessity in the genome evolution of endosymbiotic bacteria of insects

[EN] An open question in evolutionary biology is how does the selection¿drift balance determine the fates of biological interactions. We searched for signatures of selection and drift in genomes of five endosymbiotic bacterial groups known to evolve under strong genetic drift. Although most genes in endosymbiotic bacteria showed evidence of relaxed purifying selection, many genes in these bacteria exhibited stronger selective constraints than their orthologs in free-living bacterial relatives. Remarkably, most of these highly constrained genes had no role in the host¿symbiont interactions but were involved in either buffering the deleterious consequences of drift or other host-unrelated functions, suggesting that they have either acquired new roles or their role became more central in endosymbiotic bacteria. Experimental evolution of Escherichia coli under strong genetic drift revealed remarkable similarities in the mutational spectrum, genome reduction patterns and gene losses to endosymbiotic bacteria of insects. Interestingly, the transcriptome of the experimentally evolved lines showed a generalized deregulation of the genome that affected genes encoding proteins involved in mutational buffering, regulation and amino acid biosynthesis, patterns identical to those found in endosymbiotic bacteria. Our results indicate that drift has shaped endosymbiotic associations through a change in the functional landscape of bacterial genes and that the host had only a small role in such a shiftThis work was supported by Science Foundation Ireland (12/IP/1637) and grants from the Spanish Ministerio de Economia y Competitividad (MINECO-FEDER; BFU2012-36346 and BFU2015-66073-P) to MAF. DAP and CT were supported by Juan de la Cierva fellowships from MINECO (references: JCI-2011-11089 and JCA-2012-14056, respectively). DAP is supported by funds from the University of Nevada, Reno, NV, USA.Sabater-Muñoz, B.; Toft, C.; Alvarez-Ponce, D.; Fares Riaño, MA. (2017). Chance and necessity in the genome evolution of endosymbiotic bacteria of insects. The ISME Journal. 11(6):1291-1304. https://doi.org/10.1038/ismej.2017.18S12911304116Aguilar-Rodriguez J, Sabater-Munoz B, Montagud-Martinez R, Berlanga V, Alvarez-Ponce D, Wagner A et al. (2016). The molecular chaperone DnaK is a source of mutational robustness. Genome Biol Evol 8: 2979–2991.Alvarez-Ponce D, Sabater-Munoz B, Toft C, Ruiz-Gonzalez MX, Fares MA . (2016). Essentiality is a strong determinant of protein rates of evolution during mutation accumulation experiments in Escherichia coli. Genome Biol Evol 8: 2914–2927.Anders S, Huber W . (2010). Differential expression analysis for sequence count data. Genome Biol 11: R106.Archibald J . (2014) One Plus One Equals One: Symbiosis and the Evolution of Complex Life. Oxford University Press: Oxford, UK.Aussel L, Loiseau L, Hajj Chehade M, Pocachard B, Fontecave M, Pierrel F et al. (2014). ubiJ, a new gene required for aerobic growth and proliferation in macrophage, is involved in coenzyme Q biosynthesis in Escherichia coli and Salmonella enterica serovar Typhimurium. J Bacteriol 196: 70–79.Baumann P, Baumann L, Clark MA . (1996). Levels of Buchnera aphidicola chaperonin groEL during growth of the aphid Schizaphis graminum. Curr Microbiol 32: 7.Benjamini Y, Yekutieli Y . (2005). False discovery rate controlling confidence intervals for selected parameters. J Am Stat Assoc 100: 10.Bennett GM, Moran NA . (2015). Heritable symbiosis: the advantages and perils of an evolutionary rabbit hole. Proc Natl Acad Sci USA 112: 10169–10176.Bermingham J, Rabatel A, Calevro F, Vinuelas J, Febvay G, Charles H et al. (2009). Impact of host developmental age on the transcriptome of the symbiotic bacterium Buchnera aphidicola in the pea aphid (Acyrthosiphon pisum. Appl Environ Microbiol 75: 7294–7297.Bogumil D, Dagan T . (2010). Chaperonin-dependent accelerated substitution rates in prokaryotes. Genome Biol Evol 2: 602–608.Carbon S, Ireland A, Mungall CJ, Shu S, Marshall B, Lewis S et al. (2009). AmiGO: online access to ontology and annotation data. Bioinformatics 25: 288–289.Chen Z, Wang Y, Li Y, Li Y, Fu N, Ye J et al. (2012). Esre: a novel essential non-coding RNA in Escherichia coli. FEBS Lett 586: 1195–1200.Clark JW, Hossain S, Burnside CA, Kambhampati S . (2001). Coevolution between a cockroach and its bacterial endosymbiont: a biogeographical perspective. Proc Biol Sci 268: 393–398.Dale C, Wang B, Moran N, Ochman H . (2003). Loss of DNA recombinational repair enzymes in the initial stages of genome degeneration. Mol Biol Evol 20: 1188–1194.Deatherage DE, Barrick JE . (2014). Identification of mutations in laboratory-evolved microbes from next-generation sequencing data using breseq. Methods Mol Biol 1151: 165–188.Douglas AE . (2003). The nutritional physiology of aphids. Adv Insect Physiol 31: 68.Fares MA, Barrio E, Sabater-Munoz B, Moya A . (2002a). The evolution of the heat-shock protein GroEL from Buchnera, the primary endosymbiont of aphids, is governed by positive selection. Mol Biol Evol 19: 1162–1170.Fares MA, Ruiz-Gonzalez MX, Moya A, Elena SF, Barrio E . (2002b). Endosymbiotic bacteria: groEL buffers against deleterious mutations. Nature 417: 398.Gancedo C, Flores CL, Gancedo JM . (2016). The expanding landscape of moonlighting proteins in yeasts. Microbiol Mol Biol Rev 80: 765–777.Gerardo NM, Altincicek B, Anselme C, Atamian H, Barribeau SM, de Vos M et al. (2010). Immunity and other defenses in pea aphids, Acyrthosiphon pisum. Genome Biol 11: R21.Gomez-Valero L, Latorre A, Silva FJ . (2004). The evolutionary fate of nonfunctional DNA in the bacterial endosymbiont Buchnera aphidicola. Mol Biol Evol 21: 2172–2181.Gomez-Valero L, Silva FJ, Christophe Simon J, Latorre A . (2007). Genome reduction of the aphid endosymbiont Buchnera aphidicola in a recent evolutionary time scale. Gene 389: 87–95.Gonzalez-Domenech CM, Belda E, Patino-Navarrete R, Moya A, Pereto J, Latorre A . (2012). Metabolic stasis in an ancient symbiosis: genome-scale metabolic networks from two Blattabacterium cuenoti strains, primary endosymbionts of cockroaches. BMC Microbiol 12 (Suppl 1): S5.Hansen AK, Moran NA . (2011). Aphid genome expression reveals host-symbiont cooperation in the production of amino acids. Proc Natl Acad Sci USA 108: 2849–2854.Hansen AK, Moran NA . (2014). The impact of microbial symbionts on host plant utilization by herbivorous insects. Mol Ecol 23: 1473–1496.Henderson B, Fares MA, Lund PA . (2013). Chaperonin 60: a paradoxical, evolutionarily conserved protein family with multiple moonlighting functions. Biol Rev Camb Philos Soc 88: 955–987.Humphreys NJ, Douglas AE . (1997). Partitioning of symbiotic bacteria between generations of an insect: a quantitative study of a Buchnera sp. in the pea aphid (Acyrthosiphon pisum reared at different temperatures. Appl Environ Microbiol 63: 3294–3296.International Aphid Genomics Consortium. (2010). Genome sequence of the pea aphid Acyrthosiphon pisum. PLoS Biol 8: e1000313.Kadibalban AS, Bogumil D, Landan G, Dagan T . (2016). DnaK-dependent accelerated evolutionary rate in prokaryotes. Genome Biol Evol 8: 1590–1599.Katoh K, Standley DM . (2013). MAFFT multiple sequence alignment software version 7: improvements in performance and usability. Mol Biol Evol 30: 772–780.Kelkar YD, Ochman H . (2013). Genome reduction promotes increase in protein functional complexity in bacteria. Genetics 193: 303–307.Koga R, Meng XY, Tsuchida T, Fukatsu T . (2012). Cellular mechanism for selective vertical transmission of an obligate insect symbiont at the bacteriocyte-embryo interface. Proc Natl Acad Sci USA 109: E1230–E1237.Kuo CH, Moran NA, Ochman H . (2009). The consequences of genetic drift for bacterial genome complexity. Genome Res 19: 1450–1454.Kuo CH, Ochman H . (2009). Deletional bias across the three domains of life. Genome Biol Evol 1: 145–152.Law R, Lewis DH . (1983). Biotic environments and the maintenance of sex-some evidence from mutualistic symbioses. Biol J Linnean Soc 20: 28.Liu XD, Xie L, Wei Y, Zhou X, Jia B, Liu J et al. (2014). Abiotic stress resistance, a novel moonlighting function of ribosomal protein RPL44 in the halophilic fungus Aspergillus glaucus. Appl Environ Microbiol 80: 4294–4300.Lohse M, Bolger AM, Nagel A, Fernie AR, Lunn JE, Stitt M et al. (2012). RobiNA: a user-friendly, integrated software solution for RNA-Seq-based transcriptomics. Nucleic Acids Res 40: W622–W627.Macdonald SJ, Lin GG, Russell CW, Thomas GH, Douglas AE . (2012). The central role of the host cell in symbiotic nitrogen metabolism. Proc Biol Sci 279: 2965–2973.McClure R, Balasubramanian D, Sun Y, Bobrovskyy M, Sumby P, Genco CA et al. (2013). Computational analysis of bacterial RNA-Seq data. Nucleic Acids Res 41: e140.McCutcheon JP, Moran NA . (2012). Extreme genome reduction in symbiotic bacteria. Nat Rev Microbiol 10: 13–26.McFall-Ngai M, Hadfield MG, Bosch TC, Carey HV, Domazet-Loso T, Douglas AE et al. (2013). Animals in a bacterial world, a new imperative for the life sciences. Proc Natl Acad Sci USA 110: 3229–3236.Mira A, Ochman H, Moran NA . (2001). Deletional bias and the evolution of bacterial genomes. Trends Genet 17: 589–596.Moran NA . (1996). Accelerated evolution and Muller's rachet in endosymbiotic bacteria. Proc Natl Acad Sci USA 93: 2873–2878.Moran NA, Dunbar HE, Wilcox JL . (2005). Regulation of transcription in a reduced bacterial genome: nutrient-provisioning genes of the obligate symbiont Buchnera aphidicola. J Bacteriol 187: 4229–4237.Moran NA, McCutcheon JP, Nakabachi A . (2008). Genomics and evolution of heritable bacterial symbionts. Annu Rev Genet 42: 165–190.Moran NA, McLaughlin HJ, Sorek R . (2009). The dynamics and time scale of ongoing genomic erosion in symbiotic bacteria. Science 323: 379–382.Nakabachi A, Ishida K, Hongoh Y, Ohkuma M, Miyagishima SY . (2014). Aphid gene of bacterial origin encodes a protein transported to an obligate endosymbiont. Curr Biol 24: R640–R641.Nilsson AI, Koskiniemi S, Eriksson S, Kugelberg E, Hinton JC, Andersson DI . (2005). Bacterial genome size reduction by experimental evolution. Proc Natl Acad Sci USA 102: 12112–12116.Patino-Navarrete R, Moya A, Latorre A, Pereto J . (2013). Comparative genomics of Blattabacterium cuenoti: the frozen legacy of an ancient endosymbiont genome. Genome Biol Evol 5: 351–361.Pettersson ME, Berg OG . (2007). Muller's ratchet in symbiont populations. Genetica 130: 199–211.Price DR, Feng H, Baker JD, Bavan S, Luetje CW, Wilson AC . (2014). Aphid amino acid transporter regulates glutamine supply to intracellular bacterial symbionts. Proc Natl Acad Sci USA 111: 320–325.Reyes-Prieto M, Vargas-Chavez C, Latorre A, Moya A . (2015). SymbioGenomesDB: a database for the integration and access to knowledge on host-symbiont relationships. Database 2015: bav109 (1–8).Robinson MD, McCarthy DJ, Smyth GK . (2010). edgeR: a Bioconductor package for differential expression analysis of digital gene expression data. Bioinformatics 26: 139–140.Sabater-Muñoz B, Prats-Escriche M, Montagud-Martinez R, Lopez-Cerdan A, Toft C, Aguilar-Rodriguez J et al. (2015). Fitness trade-offs determine the role of the molecular chaperonin groel in buffering mutations. Mol Biol Evol 32: 2681–2693.Schlicker A, Domingues FS, Rahnenfuhrer J, Lengauer T . (2006). A new measure for functional similarity of gene products based on Gene Ontology. BMC Bioinformatics 7: 302.Shigenobu S, Watanabe H, Hattori M, Sakaki Y, Ishikawa H . (2000). Genome sequence of the endocellular bacterial symbiont of aphids Buchnera sp. APS. Nature 407: 81–86.Supek F, Bosnjak M, Skunca N, Smuc T . (2011). REVIGO summarizes and visualizes long lists of gene ontology terms. PLoS ONE 6: e21800.Tamas I, Klasson L, Canback B, Naslund AK, Eriksson AS, Wernegreen JJ et al. (2002). 50 million years of genomic stasis in endosymbiotic bacteria. Science 296: 2376–2379.Toft C, Fares MA . (2008). The evolution of the flagellar assembly pathway in endosymbiotic bacterial genomes. Mol Biol Evol 25: 2069–2076.van Ham RC, Kamerbeek J, Palacios C, Rausell C, Abascal F, Bastolla U et al. (2003). Reductive genome evolution in Buchnera aphidicola. Proc Natl Acad Sci USA 100: 581–586.Wernegreen JJ . (2002). Genome evolution in bacterial endosymbionts of insects. Nat Rev Genet 3: 850–861.Wernegreen JJ . (2011). Reduced selective constraint in endosymbionts: elevation in radical amino acid replacements occurs genome-wide. PLoS One 6: e28905.Williams TA, Fares MA . (2010). The effect of chaperonin buffering on protein evolution. Genome Biol Evol 2: 609–619.Yang Z . (2007). PAML 4: phylogenetic analysis by maximum likelihood. Mol Biol Evol 24: 1586–1591

Primary Language and Receipt of Recommended Health Care Among Hispanics in the United States

BackgroundDisparities in health care services between Hispanics and whites in the United States are well documented.ObjectiveThe objective of the study was to determine whether language spoken at home identifies Hispanics at risk for not receiving recommended health care services.DesignThe design of the study was cross-sectional, nationally representative survey of households.PatientsThe patients were non-Hispanic white and Hispanic adults participating in the 2003 Medical Expenditure Panel Survey.MeasurementsWe compared receipt of ten recommended health care services by ethnicity and primary language adjusting for demographic and socioeconomic characteristics, health status, and access to care.ResultsThe sample included 12,706 whites and 5,500 Hispanics. In bivariate comparisons, 57.0% of whites received all eligible health care services compared to 53.6% for Hispanics who spoke English at home, 44.9% for Hispanics who did not speak English at home but who were comfortable speaking English, and 35.0% for Hispanics who did not speak English at home and were uncomfortable speaking English (p < .001). In multivariate logistic models, compared to non-Hispanic whites, Hispanics who did not speak English at home were less likely to receive all eligible health care services, whether they were comfortable speaking English (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.74-0.97) or not (RR 0.84, 95% CI 0.68-0.95).ConclusionsSpeaking a language other than English at home identified Hispanics at risk for not receiving recommended health care services, whether they were comfortable in speaking English or not. Identifying the mechanism for disparities by language usage may lead to interventions to reduce ethnic disparities

English Language Proficiency and Geographical Proximity to a Safety Net Clinic as a Predictor of Health Care Access

Studies suggest that proximity to a safety net clinic (SNC) promotes access to care among the uninsured. Distance-based barriers to care may be greater for people with limited English proficiency (LEP), compared to those who are English proficient (EP), but this has not been explored. We assessed the relationship between distance to the nearest SNC and access in non-rural uninsured adults in California, and examined whether this relationship differs by language proficiency. Using the 2005 California Health Interview Survey and a list we compiled of California’s SNCs, we calculated distance between uninsured interviewee residence and the exact address of the nearest SNC. Using multivariate regression to adjust for other relevant characteristics, we examined associations between this distance and interviewee’s probability of having a usual source of health care (USOC) and having visited a physician in the prior 12 months. To examine differences by language proficiency, we included interactions between distance and language proficiency. Uninsured LEP adults living within 2 miles of a SNC were 9.3% less likely than their EP counterparts to have a USOC (P = 0.046). Further, distance to the nearest SNC was inversely associated with the probability of having a USOC among LEP, but not among EP; consequently, the difference between LEP and EP in the probability of having a USOC widened with increasing distance to the nearest SNC. There was no difference between LEP and EP adults living within 2 miles of a SNC in likelihood of having a physician visit; however, as with USOC, distance to the nearest SNC was inversely associated with the probability of having a physician visit among LEP but not EP. The effect sizes diminished, but remained significant, when we included county fixed effects in the models. Having LEP is a barrier to health care access, which compounds when combined with increased distance to the nearest SNC, among uninsured adults. Future studies should explore potential mechanisms so that appropriate interventions can be implemented

Residential traffic exposure and pregnancy-related outcomes: a prospective birth cohort study

Background. The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts. Methods. We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1) distance-weighted traffic density in a 150 meter radius, and 2) proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (pre)eclampsia, and gestational diabetes. Results. There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses. Conclusions. Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account

Human Papilloma Virus vaccine and cervical cancer screening acceptability among adults in Quebec, Canada

<p>Abstract</p> <p>Background</p> <p>The Pap test has been used for cervical cancer screening for more than four decades. A human papillomavirus (HPV) vaccine has been approved for use in Canada and is commercially available now. These two preventive interventions should be considered simultaneously. General population support is an important factor for the successful combination of these interventions. The study had two objectives: 1) To assess practices, beliefs, and attitudes regarding Pap test screening and HPV immunization; 2) To identify socio-demographic factors for Pap screening and vaccine acceptability.</p> <p>Methods</p> <p>In 2006, 500 adults were invited to participate in a telephone survey in the region of Quebec City (urban and rural population, 600 000), Canada. Some neutral and standardized information on Pap test and HPV was provided before soliciting opinions.</p> <p>Results</p> <p>471 adults (18–69 year-olds) answered the questionnaire, the mean age was 45 years, 67% were female, and 65% had college or university degree. Eighty-six percent of women had undergone at least one Pap-test in their life, 55% in the last year, and 15% from 1 to 3 years ago. Among screened women, the test had been performed in the last three years in 100% of 18–30 year-olds, but only in 67% of 60–69 year-olds (P < 0.0001). Only 15% of respondents had heard of HPV. Eighty-seven percent agreed that HPV vaccines could prevent cervical cancer, 73% that the vaccine has to be administered before the onset of sexual activity, 89% would recommend vaccination to their daughters and nieces. Among respondents < 25 years, 91% would agree to receive the vaccine if it is publicly funded, but only 72% would agree to pay $100/dose.</p> <p>Conclusion</p> <p>There is an important heterogeneity in cervical cancer screening frequency and coverage. Despite low awareness of HPV infection, the majority of respondents would recommend or are ready to receive the HPV vaccine, but the cost could prevent its acceptability.</p

Disparities in mammographic screening for Asian women in California: a cross-sectional analysis to identify meaningful groups for targeted intervention

<p>Abstract</p> <p>Background</p> <p>Breast cancer is the most commonly diagnosed cancer among the rapidly growing population of Asian Americans; it is also the most common cause of cancer mortality among Filipinas. Asian women continue to have lower rates of mammographic screening than women of most other racial/ethnic groups. While prior studies have described the effects of sociodemographic and other characteristics of women on non-adherence to screening guidelines, they have not identified the distinct segments of the population who remain at highest risk of not being screened.</p> <p>Methods</p> <p>To better describe characteristics of Asian women associated with not having a mammogram in the last two years, we applied recursive partitioning to population-based data (N = 1521) from the 2001 California Health Interview Survey (CHIS), for seven racial/ethnic groups of interest: Chinese, Japanese, Filipino, Korean, South Asian, Vietnamese, and all Asians combined.</p> <p>Results</p> <p>We identified two major subgroups of Asian women who reported not having a mammogram in the past two years and therefore, did not follow mammography screening recommendations: 1) women who have never had a pap exam to screen for cervical cancer (68% had no mammogram), and 2) women who have had a pap exam, but have no women's health issues (osteoporosis, using menopausal hormone therapies, and/or hysterectomy) nor a usual source of care (62% had no mammogram). Only 19% of Asian women who have had pap screening and have women's health issues did not have a mammogram in the past two years. In virtually all ethnic subgroups, having had pap or colorectal screening were the strongest delineators of mammography usage. Other characteristics of women least likely to have had a mammogram included: Chinese non-U.S. citizens or citizens without usual source of health care, Filipinas with no health insurance, Koreans without women's health issues and public or no health insurance, South Asians less than age 50 who were unemployed or non-citizens, and Vietnamese women who were never married.</p> <p>Conclusion</p> <p>We identified distinct subgroups of Asian women at highest risk of not adhering to mammography screening guidelines; these data can inform outreach efforts aimed at reducing the disparity in mammography screening among Asian women.</p