An ecological analysis of geographic variations in the need and availability of safety net facilities in racially segregated communities of Chicago

Health Care Disparities;Racial Residential Segregation;Safety Net Facilities;Access to Care

Bradford, Natalie ; Grigsby-Toussaint ; Diana

关键词: Health Care Disparities;    Racial Residential Segregation;    Safety Net Facilities;    Access to Care;   

Others  :  https://www.ideals.illinois.edu/bitstream/handle/2142/50354/Natalie_Bradford.pdf?sequence=1&isAllowed=y

美国|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

A growing body of literature hypothesizes that racial residential segregation is a fundamental cause of racial disparities in health and access to care in the United States.Safety net facilities, however, have the potential to play a major role in eliminating such disparities by improving access to care for vulnerable populations especially in racially segregated communities.The following study uses an ecological study design to examine the effect of Black residential segregation on the need for and availability of safety net facilities across communities and regions within the city of Chicago, Illinois. Several data sources are used to identify the location of community health centers, free clinics, safety net hospitals, and local health departments that comprise the health care safety net in Chicago community areas.Descriptive statistics were calculated to measure differences in Black residential segregation, poverty, and the uninsured population across Chicago’s 77 community areas and 7 health systems planning regions.Nonparametric correlation analyses were performed to determine the relationship between segregation and both the need for and availability of safety net facilities.The correlation between the need for and availability of safety net facilities was tested as well.All data and measures were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. Descriptive statistics show that measures of Black residential segregation, indicators of local safety net need (i.e., the poverty rate and percent of uninsured residents in a given area), and the availability of safety net facilities vary substantially across Chicago.Although correlations analyses also varied among Chicago regions, Black residential segregation was significantly correlated with both the poverty rate and percent of uninsured residents.The availability of safety net facilities was correlated with segregation and the need for safety net facilities.Results suggest that segregated Black communities heavily populated by vulnerable uninsured and low-income residents may have limited access to safety net facilities.Chicago community areas in the Northwest and South regions appear to be particularly underserved.Analyses from the results of this study can aid health care reform efforts aimed at expanding health care services (i.e., safety net facilities) available to vulnerable populations and in medically underserved areas such as segregated Black communities.