Background Most health surveys ask women whether they have had a recent mammogram, all of which report mammography use (past two years) at about 70–80% regardless of race or residence. We examined the potential extent of over-reporting of mammography use in low income African-American and Latina women, and whether self-report inaccuracies might bias estimated associations between patient characteristics and mammography use. Methods Using venue based sampling in two poor communities on the west side of Chicago, we asked eligible women living in two west side communities of Chicago to complete a survey about breast health (n=2,200) and to provide consent to view their medical record. Of the n=1,909 women who screened eligible for medical record review, n=1,566 consented (82%). We obtained medical records of all women who provided both permission and a valid local mammography facility (n=1,221). We compared the self-reported responses from the survey to the imaging reports found in the medical record (documented). To account for missing data we conducted multiple imputations for key demographic variables and report standard measures of accuracy. Results Although 73% of women self-reported a mammogram in the last 2 years, only 45% of self-reports were documented. Over-reporting of mammography use was observed for all three ethnic groups. Conclusions These results suggest considerable over-estimation of prevalence of use in these vulnerable populations. Impact Relying on known faulty self-reported mammography data as a measure of mammography use provides an overly optimistic picture of utilization, a problem that may be exacerbated in vulnerable minority communities.

The local-level variations in health revealed in this study emphasize that geographic and racial/ethnic health disparities are still prominent in Chicago and shed light on the limitations of existing city- and regional-level data.

The high proportions of current smokers who had attempted to quit indicate a prevalent desire to stop smoking. However, less than 4% of the Master Tobacco Settlement Agreement funds are being spent on smoking prevention, or even on health in general, in Illinois. Although much is known about the prevalence of smoking at the national level, few studies of smoking have been done at the community level, presenting difficulties for the allocation of resources and the design of smoking cessation programs in response to community needs. Understanding community-level smoking rates could improve the allocation of resources and assist the shaping of culturally meaningful prevention efforts.