Physician accessibility: an urban case study of pediatric providers

Guagliardo, Mark F.; Ronzio, Cynthia R.; Cheung, Ivan; Chacko, Elizabeth; Joseph, Jill G.

doi:10.1016/j.healthplace.2003.01.001

Cited by 167 publications

(129 citation statements)

References 36 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…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%

“…For example, a recent study of Washington, DC, found that almost all areas with substandard spatial accessibility of pediatric primary care providers were predominately AfricanAmerican. 45 Thus, it was also important to investigate whether the relationship between neighborhood poverty and the spatial accessibility of facilities offering low-or no-fee mammograms differs by the proportion of African-American residents in the neighborhood.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Zenk

Tarlov²,

Sun³

2006

J Urban Health

View full text Add to dashboard Cite

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.

show abstract

Section: Neighborhood Variation In Spatial Accessibility Of Mammograpmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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

Zenk

Tarlov²,

Sun³

2006

J Urban Health

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…This method has been described previously. 17,18 Briefly, we created 2 density maps of our study region. One represented provider density, and the other represented child-population density.…”

Section: Methodsmentioning

confidence: 99%

Spatial Accessibility of Primary Care Pediatric Services in an Urban Environment: Association With Asthma Management and Outcome

et al. 2006

View full text Add to dashboard Cite

BACKGROUND. Disadvantaged urban children with asthma depend heavily on emergency departments (EDs) for episodic care. We hypothesized that among an urban population of children with asthma, higher spatial accessibility to primary care pediatric services would be associated with (1) more scheduled primary care visits for asthma, (2) better longitudinal asthma management, and (3) fewer unscheduled visits for asthma care.

show abstract

Physician accessibility: an urban case study of pediatric providers

Cited by 167 publications

References 36 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

Spatial Accessibility of Primary Care Pediatric Services in an Urban Environment: Association With Asthma Management and Outcome

Contact Info

Product

Resources

About