2010年《平价医疗法案》实施后，美国未参保人口大幅减少。截至 2022 年，美国约有 2640 万人没有保险。缺乏保险和获得服务的机会对该国的少数群体造成了不成比例的影响，反映了健康问题社会决定因素对其未参保状况的影响。乳房X光检查是一种有效的方法，可以早期发现乳腺癌并降低乳腺癌死亡率，但由于COVID-19大流行期间的封锁和恐惧，所有种族的女性都推迟或推迟了乳房X线检查的使用。从那时起，少数族裔恢复乳房X光检查的速度一直滞后，进一步扩大了他们不成比例的筛查差距。放射科医生（更具体地说是乳腺成像师）必须认识到这些问题，因为没有保险的人和属于少数群体的人在晚期被诊断出患有乳腺癌，死亡率更高，护理连续性较差，总体生存率较低。本文的目的是让放射科医生熟悉未参保人群，解释他们如何受到乳腺癌的影响，并提出乳腺成像人员可以采取的策略，以改善筛查机会并减少该患者群体的依从性差距。 ©RSNA，2023 请参阅本期 Nguyen 特邀评论。本文的测验问题可通过在线学习中心获得。

After implementation of the Affordable Care Act in 2010, the uninsured population of the United States decreased significantly. As of 2022, there were approximately 26.4 million uninsured individuals in the United States. The lack of coverage and access to services disproportionally affect minority groups in the country, reflecting the influence of the social determinants of health in their uninsured status. Use of screening mammography, an effective modality that results in early detection of and decreased mortality from breast cancer, was delayed or postponed by women of all races due to lockdowns and fear during the COVID-19 pandemic. Since then, the return to mammographic screening has lagged among minorities, further increasing their disproportionate screening gap. Radiologists-and more specifically breast imagers-must recognize these issues, as people who are uninsured and part of minority groups are diagnosed with breast cancer at later stages and have higher mortality rates, less continuity of care, and overall lower survival. The purpose of this article is to familiarize radiologists with the uninsured population, explain how they are disproportionally affected by breast cancer, and propose strategies that breast imagers can pursue to improve screening access and decrease compliance gaps for this patient population. ©RSNA, 2023 See the invited commentary by Nguyen in this issue. Quiz questions for this article are available through the Online Learning Center.