Optimizing mobile mammography deployment in Oklahoma 2024: a two-step floating catchment area approach

This study assessed spatial accessibility to fixed mammography centres across Oklahoma State, USA using the Two-Step Floating Catchment Area (2SFCA) and the Enhanced Two-Step Floating Catchment Area (E2SFCA) methods to identify areas with limited or no access. For this analysis, we used data from the mammography facilities database of the US Food and Drug Administration verified by direct contact with the facility and the U.S. Census block group population and demographics for women aged 40 years and older. Analyses were stratified by urban areas; large rural areas; and small rural areas. Accessibility scores were calculated using the 2SFCA method with 30-minute drive times and the E2SFCA method with drive times of 10, 20 and 30 minutes weighted by distance decay. Block groups were categorized into quartiles based on accessibility scores. Among 940,994 eligible women, 10% lived in areas with no access. Small rural regions faced the greatest barriers. Spatial disparities were linked to racial and socioeconomic differences: non-Hispanic American Indian/Alaska Native and non-Hispanic White populations were more likely to reside in noaccess zones, while Black and Hispanic populations clustered in high-access urban areas. Spatial analysis reveals significant rural disparities in mammography access. Mobile machines should prioritize underserved rural regions to improve equity.