Persistent Inequalities in Health and Access to Health Services: Evidence From New York City

Gusmano, Michael K.; Rodwin, Victor G.; Weisz, Daniel

doi:10.1002/wmh3.226

Cited by 14 publications

(10 citation statements)

References 47 publications

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“…The study corroborates with the literature reporting "racial, ethnic, and neighborhood-level inequalities in health and healthcare are a long-standing problem in the United States" (Gusmano et al 2017;187). Furthermore, persistent inequalities of neighborhoods, including income inequality, racial segregation, and concentrated poverty, remain barriers to reducing and eliminating disparities in access to healthcare and, ultimately, achieving health equity.…”

Section: Discussionsupporting

confidence: 89%

“…A plethora of literature suggests an association between race, ethnicity, and health as a primary function of socioeconomic status (income and education) (Lawrence, 2002). At the neighborhood-level, race-based residential discrimination and segregation among blacks and Hispanics, along with high concentrations of poverty "sustain racial patterns of healthcare delivery," where blacks and Hispanics more likely to be uninsured and face financial disadvantages with medical debt (Gusmano et al 2017;188). As a limitation the study is primarily descriptive due to its small sample.…”

Section: Discussionmentioning

confidence: 99%

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Factors Associated with COVID-19 Infection, Hospitalization and Death in New York City Neighborhoods

Gu¹,

Shafeeq²,

Chen³

et al. 2021

Innov Pharm

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Background: A key to an effective Coronavirus 2019 (COVID-19) Community Intervention is to understand populations who are most vulnerable to it. We aimed at evaluating characteristics of New York City communities where rates of confirmed COVID-19 cases were particularly high. Methods: The study outcomes - neighborhood-specific confirmed COVID-19 cases, positive tests, and COVID-19 attributable deaths were calculated using data extracted from the New York City government health website, which were linked to results from Community Health Survey. Distributions of study outcomes across New York City community districts and their associations with neighborhood characteristics were examined using Jonckheere-Terpstra tests. Results: As of May 21, 2010, rates of confirmed cases ranged from 0.8% (Greenwich Village and Soho) to 3.9% (Jackson Heights), and the rates of attributable death from to 0.6‰ (Greenwich Village and Soho) to 4.2‰ (Coney Island). Higher percentages of black, Hispanic and foreign-born populations, lower educational attainment, poverty, lack of health insurance, and suboptimal quality of health care were all factors found to be correlated with increased rates of confirmed COVID-19 cases. Conclusions: The epidemiology of COVID-19 exhibited great variations among neighborhoods in New York City. Community interventions aimed at COVID-19 prevention and mitigation should place high priorities in areas with large populations of blacks and Hispanics and economically disadvantages areas.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Factors Associated with COVID-19 Infection, Hospitalization and Death in New York City Neighborhoods

Gu¹,

Shafeeq²,

Chen³

et al. 2021

Innov Pharm

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“…An analysis of access to primary care in NYC found that gender, insurance status, racial, ethnic, and neighborhood-level disparities did not change over the course of the Bloomberg administration. 14 Our findings on revascularization are similar. Although there were notable reductions in racial and ethnic disparities in the use of revascularization procedures, gender, insurance status, and neighborhood-level differences were conspicuously stable over the time periods we examined.…”

Section: Introductionsupporting

confidence: 72%

Disparities in Access to Revascularization: Evidence from New York

et al. 2019

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Purpose: To quantify and compare citywide disparities in the performance of coronary revascularization procedures in New York residents diagnosed with ischemic heart disease (IHD) by the characteristics of the patients and their neighborhood of residence in 2000–2002 and 2011–2013. Methods: We identify the number of hospitalizations for patients with diagnoses of IHD and/or congestive heart failure (CHF) and the number of revascularization procedures performed on the population 45 years and older, relying on hospital administrative data for New York City, by area of residence, from the Statewide Planning and Research Cooperative System (SPARCS). We conduct multiple logistic regressions to analyze the factors associated with revascularization for hospitalized patients admitted with IHD and CHF over the two time periods. Results: Despite any decline in population health status, both the age-adjusted rates of inpatient hospital discharges for acute myocardial infarction, for IHD and for CHF, decreased as did the rates of revascularization procedures. Racial and ethnic disparities were much smaller in the later period than those documented earlier. However, there were persistent gender, insurance status, and neighborhood-level disparities in the treatment of heart disease. Conclusions: With the declines in rates of heart disease, our findings point to the need for more clinical and population-based research to improve the understanding of why race/ethnicity, gender, insurance status, and neighborhood-level disparities persist in the treatment of heart disease.

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“…Yet another hypothesis is that reductions in the ACSC rate depend not only on extending insurance but on addressing underlying social factors that lead to poor health, poor health behaviours and different health-seeking behaviours. Although we found that the ACSC rate in New York fell by about half, between 2000 and 2013, the differences by insurance status, race, ethnicity and neighbourhood have not changed over this period (Gusmano et al ., 2017). As Bradley et al .…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators

Gusmano¹,

Strumpf

Fiset-Laniel

et al. 2018

HEPL

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Although eliminating financial barriers to care is a necessary condition for improving access to health services, it is not sufficient. Given the contrasting health systems with regard to financing and organization of health insurance in the United States and Canada, there is a long history of comparing these countries. We extend the empirical studies on the Canadian and US health systems by comparing access to ambulatory care as measured by hospitalization rates for ambulatory care sensitive conditions (ACSC) in Montreal and New York City. We find that, in New York, ACSC rates were more than twice as high (12.6 per 1000 population) as in Montreal (4.8 per 1000 population). After controlling for age, sex, and number of diagnoses, significant differences in ACSC rates are present in both cities, but are more pronounced in New York. Our findings are consistent with the hypothesis that universal, first-dollar health insurance coverage has contributed to lower ACSC rates in Montreal than New York. However, Montreal's surprisingly low ACSC rate calls for further research.

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Persistent Inequalities in Health and Access to Health Services: Evidence From New York City

Cited by 14 publications

References 47 publications

Factors Associated with COVID-19 Infection, Hospitalization and Death in New York City Neighborhoods

Factors Associated with COVID-19 Infection, Hospitalization and Death in New York City Neighborhoods

Disparities in Access to Revascularization: Evidence from New York

Comparative analysis of health system performance in Montreal and New York: the importance of context for interpreting indicators

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