Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region

Luo, Wenjun; Wang, Fahui

doi:10.1068/b29120

Cited by 1,263 publications

(1,154 citation statements)

References 25 publications

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“…Some prior studies have found that the spatial accessibility of health care facilities, such as primary care, differs by the SES or racial/ethnic composition of urban neighborhoods, 45,65,66 though the evidence is not consistent. 67,68 This study adds to a growing literature suggesting that the spatial accessibility of some health resources (e.g., supermarkets) and risks (e.g., liquor stores) varies by both the socioeconomic and racial/ethnic characteristics of urban neighborhoods.…”

Section: Neighborhood Variation In Spatial Accessibility Of Mammograpmentioning

confidence: 90%

Spatial Equity in Facilities Providing Low- or No-Fee Screening Mammography in Chicago Neighborhoods

Zenk

Tarlov²,

Sun³

2006

J Urban Health

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Recent research suggests living in an economically disadvantaged neighborhood is associated with decreased likelihood of undergoing mammography and increased risk of late-stage breast cancer diagnosis. Long distances and travel times to facilities offering low-or no-fee mammography may be important barriers to adherence to mammography screening recommendations for women living in economically disadvantaged urban neighborhoods, in which African-Americans are disproportionately represented. The purpose of this study was to examine whether the spatial distribution of facilities providing low-or no-fee screening mammography in Chicago, Illinois, is equitable on the basis of neighborhood socioeconomic and racial characteristics. We found that distance and travel times via automobile and public transportation to facilities generally decrease as neighborhood poverty increases. However, we also found that the strength of the association between neighborhood poverty level and two of the spatial accessibility measures-distance and public transportation travel time-is less strong in African-American neighborhoods. Among neighborhoods with the greatest need for facilities (i.e., neighborhoods with the highest proportions of residents in poverty), African-American neighborhoods have longer travel distances and public transportation travel times than neighborhoods with proportionately fewer African-American residents. Thus, it appears that the spatial accessibility of low-and no-fee mammography services is inequitable in Chicago. In view of persistent social disparities in health such as breast cancer outcomes, these findings suggest it is important for researchers to examine the spatial distribution of health resources by both the socioeconomic and racial characteristics of urban neighborhoods.

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Section: Neighborhood Variation In Spatial Accessibility Of Mammograpmentioning

confidence: 90%

Spatial Equity in Facilities Providing Low- or No-Fee Screening Mammography in Chicago Neighborhoods

Zenk

Tarlov²,

Sun³

2006

J Urban Health

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“…This construct is distinct from "aspatial access," which refers to barriers and facilitators of healthcare access that are not rooted in geography (e.g., stigma 62,63 ). 61,64 We also focus on potential spatial access to ESAP pharmacies, which concerns reasonable possible use, rather than revealed (or actual) service use. 61,[65][66][67] We operationalized this construct in a two-stage process.…”

Section: Methodsmentioning

confidence: 99%

“…Drawing on research on health services geography, [59][60][61] we define "spatial access to ESAP pharmacies" as a property of each health district that reflects the local availability of pharmacies enrolled in the ESAP program in a given year. This construct is distinct from "aspatial access," which refers to barriers and facilitators of healthcare access that are not rooted in geography (e.g., stigma 62,63 ).…”

Section: Methodsmentioning

confidence: 99%

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

et al. 2009

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Pharmacies that sell over-the-counter (OTC) syringes are a major source of sterile syringes for injection drug users in cities and states where such sales are legal. In these cities and states, however, black injectors are markedly less likely to acquire syringes from pharmacies than white injectors. The present analysis documents spatial and temporal trends in OTC pharmacy access in New York City health districts over time (2001)(2002)(2003)(2004)(2005)(2006) and investigates whether these trends are related to district racial/ ethnic composition and to local need for OTC pharmacies. For each year of the study period, we used kernel density estimation methods to characterize spatial access to OTC pharmacies within each health district. Higher values on this measure indicate better access to these pharmacies. "Need" was operationalized using two different measures: the number of newly diagnosed injection-related AIDS cases per 10,000 residents (averaged across 1999-2001), and the number of drug-related hospital discharges per 10,000 residents (averaged across 1999-2001). District sociodemographic characteristics were assessed using 2000 US decennial census data. We used hierarchical linear models (HLM) for descriptive and inferential analyses and investigated whether the relationship between need and temporal trajectories in the Expanded Syringe Access Demonstration Program access varied by district racial/ethnic composition, controlling for district poverty rates. HLM analyses indicate that the mean spatial access to OTC pharmacies across New York City health districts was 12.71 in 2001 and increased linearly by 1.32 units annually thereafter. Temporal trajectories in spatial access to OTC pharmacies depended on both need and racial/ethnic composition. Within high-need districts, OTC pharmacy access was twice as high in 2001 and increased three times faster annually, in districts with higher proportions of non-Hispanic white residents than in districts with low proportions of these residents. In low-need districts, "whiter" districts had substantially greater baseline access to OTC pharmacies than districts with low proportions of non-Hispanic white residents. Access remained stable thereafter in low-need districts, regardless of racial/ethnic composition. Conclusions were consistent across both measures of "need" and persisted after controlling for local poverty rates. In both high-and low-need districts, spatial access to OTC pharmacies was greater in "Whiter" districts in 2001; in high-need 929districts, access also increased more rapidly over time in "whiter" districts. Ensuring equitable spatial access to OTC pharmacies may reduce injection-related HIV transmission overall and reduce racial/ethnic disparities in HIV incidence among injectors.

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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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Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region

Cited by 1,263 publications

References 25 publications

Spatial Equity in Facilities Providing Low- or No-Fee Screening Mammography in Chicago Neighborhoods

Spatial Equity in Facilities Providing Low- or No-Fee Screening Mammography in Chicago Neighborhoods

Temporal Trends in Spatial Access to Pharmacies that Sell Over-the-Counter Syringes in New York City Health Districts: Relationship to Local Racial/Ethnic Composition and Need

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

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