Neighbourhoods and potential access to health care: The role of spatial and aspatial factors

Bissonnette, Laura; Wilson, Kathi; Bell, Scott; Shah, Tayyab

doi:10.1016/j.healthplace.2012.03.007

Cited by 166 publications

(148 citation statements)

References 88 publications

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“…Examining finer geographic variations in provider supply, characteristics, and preferential localization (e.g., concentration around tertiary care centers) can thus be very informative. Recent advances in floating catchment area (FCA) methods [79][80][81] (e.g., using a three-step FCA [82][83][84] or utilizing a dynamic catchment size 85 ) to characterize spatial access to care in neighborhoods' local areas appear to be particularly promising.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area

2016

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Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics). We found no evidence that residence in a low-income (versus high-income) neighborhood was associated with poorer overall access. However, low-income neighborhood residence was associated with less reliance on physician offices [−4.40 percentage points; 95 % confidence intervals (CI) −5.80, −3.00] and greater reliance on the safety net provided by health centers [2.08; 95 % CI 1.42, 2.75] and outpatient clinics [1.61; 95 % CI 0.97, 2.26]. These patterns largely persisted over the 10 years investigated. These findings suggest that safety-net providers have continued to play an important role in ensuring access to primary care in urban, low-income communities, further underscoring the importance of supporting a strong safety net to ensure equitable access to care regardless of place of residence.

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Section: Discussionmentioning

confidence: 99%

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area

2016

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“…The measure of healthcare accessibility presented in this study needs to be understood as a measure of potential access to healthcare. Neighborhood-level potential access to healthcare has an impact on health [2]. On the other hand, neighborhood-level deprivation has been proven to influence self-reported individual health [41].…”

Section: Discussionmentioning

confidence: 99%

“…Deprivation and limited access to healthcare are disadvantages related to health outcomes, and are indicators that can be reported in spatial units at different scales [1][2][3][4][5][6][7][8][9][10]. Deprivation is defined as a set of social and material disadvantages [11], and is commonly calculated by combining socioeconomic information related to small census areas [8].…”

Section: Introductionmentioning

confidence: 99%

Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Cabrera-Barona

2017

Urban Science

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Self-reported health is considered a health outcome related to neighborhood characteristics. This study analyzes the influence of urban multi-criteria deprivation and spatial accessibility to healthcare on individual self-reported health from a case study carried out in the city of Quito, Ecuador. A multi-criteria deprivation index and two alternative scenarios of this index were generated. A gravity-based measure of spatial accessibility to healthcare was also calculated. The neighborhood effects of deprivation measures and spatial accessibility to healthcare on individual self-reported health were evaluated by applying multilevel models. Significant neighborhood effects were found in two of the three applied multilevel models. This study contributes evidence of neighborhood effects on health outcomes, and can support urban planners and policy-makers in the reduction of urban health-related inequalities.

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“…Health analyses with implications in decision making have widely used measures of healthcare accessibility and social deprivation Bissonnette et al 2012;Boyle et al 2001;Cabrera-Barona et al 2015;Carstairs 1995;Crooks and Schuurman 2012;Delamater 2013;Havard et al 2008;Hiscock et al 2008;Lalloué et al 2013;Luo 2014;Wan et al 2013). There are different indicators that can be used to represent deprivation and health.…”

Section: Introductionmentioning

confidence: 99%

Deprivation, Healthcare Accessibility and Satisfaction: Geographical Context and Scale Implications

Cabrera-Barona

Blaschke

Gaona

2017

Appl. Spatial Analysis

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Indices explaining health phenomena are important tools for identifying and investigating health inequalities and to support policy making. Some of these indices are expressed at area-level, and the investigation of the areal influences of these indices on individual health outcomes have scale and geographical contextual implications that need to be assessed. In this study we calculated two area-level indices: one deprivation index and one index of healthcare accessibility. Using multilevel modelling, we calculated the area-level influences of these indices on an individual-level index of healthcare satisfaction considering three kinds of areas or contexts: a context of deprivation, a context of healthcare accessibility and a context combining the two characteristics of healthcare accessibility and deprivation. We evaluated two kinds of geographical problems using the statistical results of these area-level influences: the modifiable areal unit problem (MAUP) and the uncertain geographic context problem (UGCoP). Regarding the MAUP we evaluated the scale effects at two scales: census blocks and census tracts. Regarding the UGCoP we evaluated the differences in areal influences between the three kinds of contexts for both scales. The case study area was the city of Quito, Ecuador. The results of the performed analyses showed no severe MAUP and UGCoP, and revealed important evidence of the area-level influence of deprivation and healthcare accessibility on healthcare satisfaction.

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Neighbourhoods and potential access to health care: The role of spatial and aspatial factors

Cited by 166 publications

References 88 publications

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area

Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Deprivation, Healthcare Accessibility and Satisfaction: Geographical Context and Scale Implications

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