The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care. (July 2017)

• Record Type: Journal Article
• Authors: Seymour, Jane W.; Polsky, Daniel E.; Brown, Elizabeth J.; Barbu, Corentin M.; Grande, David
• Is Part Of: Journal of primary care & community health. Volume 8:Number 3(2017:Jul.)
• Page Start: 147
• Page End: 152
• Publication Date: 2017-07
• Subjects: access to care -- primary care -- community health centers -- racial disparities -- spatial access; Primary health care -- Periodicals; Primary health care -- United States -- Periodicals; Community health services -- Periodicals; Community health services -- United States -- Periodicals; 362.12
• DOI: 10.1177/2150131917699029
• Languages: English
• ISSNs: 2150-1319

Abstract

Introduction: Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities.Methods: We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility.Results: Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7.84, P = 0.001) were more likely to be near a CHC and those with moderate rates of uninsurance (10%-19% vs <10%, OR = 0.42, P = .045) were less likely. Racial composition was not associated with proximity. Tracts close to a CHC were less likely (OR = 0.11, P < .0001) to be in a low access area. This association did not differ based on racial composition.Discussion: Although CHCs were more likely to be in areas with a greater fraction of racial minorities, location was more strongly influenced by public insurance rates. CHCs reduced the likelihood of being in low access areas but the effect did not vary by tract racial composition.