The Journal of Primary Prevention

, Volume 30, Issue 5, pp 531–547

Psychological Distress as a Barrier to Preventive Healthcare Among U.S. Women


    • Department of Population Health Sciences, School of Medicine and Public HealthUniversity of Wisconsin
  • Robert Kahn
    • Cincinnati Children’s Hospital Medical CenterUniversity of Cincinnati College of Medicine
  • Lisa Fortuna
    • Department of Psychiatry S7-410University of Massachusetts Medical School
  • Jonathan Winickoff
    • MassGeneral Hospital for ChildrenHarvard University School of Medicine
  • Karen Kuhlthau
    • MassGeneral Hospital for ChildrenHarvard University School of Medicine
  • Paul A. Pirraglia
    • Providence VA Medical Center and Warren Alpert Medical School of Brown University
  • Timothy Ferris
    • MassGeneral Hospital for ChildrenHarvard University School of Medicine
Original Paper

DOI: 10.1007/s10935-009-0190-z

Cite this article as:
Witt, W.P., Kahn, R., Fortuna, L. et al. J Primary Prevent (2009) 30: 531. doi:10.1007/s10935-009-0190-z


To examine the role of psychological distress in accessing routine periodic health examinations among U.S. women of reproductive age, we examined data on 9,166 women aged 18–49 years from the 1998 National Health Interview Survey. In multivariate regression, women with psychological distress were more likely than non-distressed women to report delayed routine care, not having insurance, and lack of a usual source of care. Among women without a usual source of care, distressed women were more than six and one-half times more likely to delay care compared with non-distressed women. Women with psychological distress report delays in receiving routine care. Editors’ Strategic Implications: The findings suggest that, for distressed women in particular, continuity of care is vital in accessing routine care and obtaining timely and effective preventive services.


Psychological distressUsual source of carePreventive healthcareWomen’s mental health

Copyright information

© Springer Science+Business Media, LLC 2009