Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
To the Editor: Dr Nelson and colleagues1 found that the rates of safety belt use, mammography,
and adult vaccinations increased in most states in the 1990s, while the rates
for other important health risk factors and clinical preventive services varied
or worsened. The authors note that state mandates for insurance coverage of
mammograms were one likely contributor to the increase in the rates of mammography.
Although state mandates may play a role in increasing the delivery of other
clinical preventive services, preliminary data demonstrate that state mandates
currently apply to an inconsistent array of preventive services.2
State mandates are most common for mammography, but few states mandate coverage
of counseling and behavioral interventions to address unhealthy behaviors
such as tobacco use, alcohol use, and other risk factors. More states (n=27)
mandate coverage of prostate cancer screening than colorectal cancer screening
(n=17), despite the fact that much stronger evidence exists for the benefits
of screening for colorectal cancer.
Bondi MA, Atkins D. State Mandates for Preventive Health Services. JAMA. 2002;288(10):1233. doi:10.1001/jama.288.10.1229