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Journal of Cancer Epidemiology
Volume 2016 (2016), Article ID 7284303, 11 pages
http://dx.doi.org/10.1155/2016/7284303
Research Article

The Influences of Health Insurance and Access to Information on Prostate Cancer Screening among Men in Dominican Republic

1Department of Geography and Environment, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
2Department of Geography, Western University, 1151 Richmond Street, London, ON, Canada N6A 5C2

Received 9 September 2015; Revised 7 January 2016; Accepted 8 February 2016

Academic Editor: Preet Dhillon

Copyright © 2016 Joseph Kangmennaang and Isaac Luginaah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Although research demonstrates the public health burden of prostate cancer among men in the Caribbean, relatively little is known about the factors that underlie the low levels of testing for the disease among this population. Study Design. A cross-sectional study of prostate cancer testing behaviours among men aged 40–60 years in Dominican Republic using the Demographic and Health Survey (2013). Methods. We use hierarchical binary logit regression models and average treatment effects combined with propensity score matching to explore the determinants of prostate screening as well as the average effect of health insurance coverage on screening. The use of hierarchical binary logit regression enabled us to control for the effect of unobserved heterogeneity at the cluster level that may affect prostate cancer testing behaviours. Results. Screening varied significantly with health insurance coverage, knowledge of cholesterol level, education, and wealth. Insured men were more likely to test for prostate cancer (OR = 1.65, ) compared to the uninsured. Conclusions. The expansion and restructuring of Dominican Republic universal health insurance scheme to ensure equity in access may improve health access that would potentially impact positively on prostate cancer screening among men.