Racial Disparities In Geographic Access To Primary Care In Philadelphia

“…A number of studies have used these types of geographic measures to describe how access to health care differs by race (Brown et al. ), by rural/urban residence (Rosenthal, Zaslavsky, and Newhouse ; Chan, Hart, and Goodman ), and over time (Eberth et al. ).…”

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confidence: 99%

Do Avoidable Hospitalization Rates among Older Adults Differ by Geographic Access to Primary Care Physicians?

Daly

Mellor

Millones

2017

Health Services Research

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“…It has been hypothesized that differences in spatial access for minority patients may contribute to documented racial/ethnic disparities in access to care and health outcomes (21, 22). Multiple studies assessing racial differences in spatial access to care, which relied on GIS-calculated travel times or distances, have yielded mixed findings.…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in Geographic Access to Medical Care as Measured by Patient Report and Geographic Information Systems

et al. 2017

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Background Geographic access – the travel burden required to reach medical care – is an important aspect of care. Studies, which typically rely on geographic information system (GIS) calculated travel times, have found some evidence of racial disparities in spatial access to care. However, the validity of these studies depends on the accuracy of travel times by patient race. Objectives To determine if there are racial differences when comparing patient-reported and geographic information system (GIS)-calculated travel times. Research Design Data came from the Philadelphia Area Prostate Cancer Access Study (P2 Access), a cohort study of men diagnosed with localized prostate cancer. We conducted cross-sectional analysis of 2136 men using multivariable linear mixed-effects models to examine the effect of race on differences in patient-reported and GIS-calculated travel times to urology and radiation oncology cancer providers. Results Patient-reported travel times were, on average, longer than GIS-calculated times. For urology practices, median patient-reported travel times were 12.7 minutes longer than GIS-calculated travel times for blacks vs. 7.2 minutes longer for whites. After adjusting for potential confounders, including socioeconomic status and car access, the difference was significantly greater for black patients than white patients (2.0 minutes, 95 percent confidence interval: 0.58, 3.44). Conclusion GIS-calculated travel time may underestimate access to care, especially for black patients. Future studies that use GIS-calculated travel times to examine racial disparities in spatial access to care might consider including patient-reported travel times and controlling for factors that might affect the accuracy of GIS-calculated travel times.

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“…[29][30][31][32] For example, low socioeconomic status is associated with fragmented or inconsistent access to care, [33][34][35][36][37][38] which may result in inadequate cancer screening and prevention. Disparities across the cancer care continuum are driven, at least in part, by socioeconomic factors.…”

Section: Potential Mechanismsmentioning

confidence: 99%

Food insecurity screening: A missing piece in cancer management

Patel

Borno

Seligman

2019

Cancer

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INTRODUCTIONFood insecurity remains an underrecognized social determinant of health. 1-3 In 2017, approximately 11.8% of US households were food insecure. These households included approximately 40 million individuals. 4 The percentage of foodinsecure households is higher among racial/ethnic minorities, single-parent and low-income households, and individuals with low levels of education. 4 Research establishing the relationships between food insecurity and many adverse health outcomes, including chronic conditions such as diabetes, is relatively mature. 5-7 However, to the best of our knowledge, the association between food insecurity and cancer outcomes remains poorly understood. In this commentary, we briefly review studies examining the relationship between food insecurity and chronic illness, particularly cancer; postulate potential mechanisms for this correlation; suggest opportunities for screening and the subsequent management of food insecurity in the cancer clinical setting; and identify areas for further research.

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Racial Disparities In Geographic Access To Primary Care In Philadelphia

Cited by 104 publications

References 26 publications

Do Avoidable Hospitalization Rates among Older Adults Differ by Geographic Access to Primary Care Physicians?

Do Avoidable Hospitalization Rates among Older Adults Differ by Geographic Access to Primary Care Physicians?

Racial Differences in Geographic Access to Medical Care as Measured by Patient Report and Geographic Information Systems

Food insecurity screening: A missing piece in cancer management

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