Residential Segregation and the Availability of Primary Care Physicians

Darrell Gaskin, Gniesha Y. Dinwiddie, Kitty S. Chan, Rachael R. McCleary

Research output: Contribution to journalArticle

Abstract

Objective To examine the association between residential segregation and geographic access to primary care physicians (PCPs) in metropolitan statistical areas (MSAs). Data Sources We combined zip code level data on primary care physicians from the 2006 American Medical Association master file with demographic, socioeconomic, and segregation measures from the 2000 U.S. Census. Our sample consisted of 15,465 zip codes located completely or partially in an MSA. Methods We defined PCP shortage areas as those zip codes with no PCP or a population to PCP ratio of >3,500. Using logistic regressions, we estimated the association between a zip code's odds of being a PCP shortage area and its minority composition and degree of segregation in its MSA. Principal Findings We found that odds of being a PCP shortage area were 67 percent higher for majority African American zip codes but 27 percent lower for majority Hispanic zip codes. The association varied with the degree of segregation. As the degree of segregation increased, the odds of being a PCP shortage area increased for majority African American zip codes; however, the converse was true for majority Hispanic and Asian zip codes. Conclusions Efforts to address PCP shortages should target African American communities especially in segregated MSAs.

Original languageEnglish (US)
Pages (from-to)2353-2376
Number of pages24
JournalHealth Services Research
Volume47
Issue number6
DOIs
StatePublished - Dec 1 2012

Fingerprint

Primary Care Physicians
Medically Underserved Area
African Americans
Hispanic Americans
Information Storage and Retrieval
American Medical Association
Censuses
Logistic Models
Demography

Keywords

  • ethnic
  • health care disparities
  • physician shortage
  • Primary care
  • racial
  • segregation

ASJC Scopus subject areas

  • Health Policy

Cite this

Residential Segregation and the Availability of Primary Care Physicians. / Gaskin, Darrell; Dinwiddie, Gniesha Y.; Chan, Kitty S.; McCleary, Rachael R.

In: Health Services Research, Vol. 47, No. 6, 01.12.2012, p. 2353-2376.

Research output: Contribution to journalArticle

Gaskin, Darrell ; Dinwiddie, Gniesha Y. ; Chan, Kitty S. ; McCleary, Rachael R. / Residential Segregation and the Availability of Primary Care Physicians. In: Health Services Research. 2012 ; Vol. 47, No. 6. pp. 2353-2376.
@article{2d70b38d49564417a7d02b752390776b,
title = "Residential Segregation and the Availability of Primary Care Physicians",
abstract = "Objective To examine the association between residential segregation and geographic access to primary care physicians (PCPs) in metropolitan statistical areas (MSAs). Data Sources We combined zip code level data on primary care physicians from the 2006 American Medical Association master file with demographic, socioeconomic, and segregation measures from the 2000 U.S. Census. Our sample consisted of 15,465 zip codes located completely or partially in an MSA. Methods We defined PCP shortage areas as those zip codes with no PCP or a population to PCP ratio of >3,500. Using logistic regressions, we estimated the association between a zip code's odds of being a PCP shortage area and its minority composition and degree of segregation in its MSA. Principal Findings We found that odds of being a PCP shortage area were 67 percent higher for majority African American zip codes but 27 percent lower for majority Hispanic zip codes. The association varied with the degree of segregation. As the degree of segregation increased, the odds of being a PCP shortage area increased for majority African American zip codes; however, the converse was true for majority Hispanic and Asian zip codes. Conclusions Efforts to address PCP shortages should target African American communities especially in segregated MSAs.",
keywords = "ethnic, health care disparities, physician shortage, Primary care, racial, segregation",
author = "Darrell Gaskin and Dinwiddie, {Gniesha Y.} and Chan, {Kitty S.} and McCleary, {Rachael R.}",
year = "2012",
month = "12",
day = "1",
doi = "10.1111/j.1475-6773.2012.01417.x",
language = "English (US)",
volume = "47",
pages = "2353--2376",
journal = "Health Services Research",
issn = "0017-9124",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Residential Segregation and the Availability of Primary Care Physicians

AU - Gaskin, Darrell

AU - Dinwiddie, Gniesha Y.

AU - Chan, Kitty S.

AU - McCleary, Rachael R.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Objective To examine the association between residential segregation and geographic access to primary care physicians (PCPs) in metropolitan statistical areas (MSAs). Data Sources We combined zip code level data on primary care physicians from the 2006 American Medical Association master file with demographic, socioeconomic, and segregation measures from the 2000 U.S. Census. Our sample consisted of 15,465 zip codes located completely or partially in an MSA. Methods We defined PCP shortage areas as those zip codes with no PCP or a population to PCP ratio of >3,500. Using logistic regressions, we estimated the association between a zip code's odds of being a PCP shortage area and its minority composition and degree of segregation in its MSA. Principal Findings We found that odds of being a PCP shortage area were 67 percent higher for majority African American zip codes but 27 percent lower for majority Hispanic zip codes. The association varied with the degree of segregation. As the degree of segregation increased, the odds of being a PCP shortage area increased for majority African American zip codes; however, the converse was true for majority Hispanic and Asian zip codes. Conclusions Efforts to address PCP shortages should target African American communities especially in segregated MSAs.

AB - Objective To examine the association between residential segregation and geographic access to primary care physicians (PCPs) in metropolitan statistical areas (MSAs). Data Sources We combined zip code level data on primary care physicians from the 2006 American Medical Association master file with demographic, socioeconomic, and segregation measures from the 2000 U.S. Census. Our sample consisted of 15,465 zip codes located completely or partially in an MSA. Methods We defined PCP shortage areas as those zip codes with no PCP or a population to PCP ratio of >3,500. Using logistic regressions, we estimated the association between a zip code's odds of being a PCP shortage area and its minority composition and degree of segregation in its MSA. Principal Findings We found that odds of being a PCP shortage area were 67 percent higher for majority African American zip codes but 27 percent lower for majority Hispanic zip codes. The association varied with the degree of segregation. As the degree of segregation increased, the odds of being a PCP shortage area increased for majority African American zip codes; however, the converse was true for majority Hispanic and Asian zip codes. Conclusions Efforts to address PCP shortages should target African American communities especially in segregated MSAs.

KW - ethnic

KW - health care disparities

KW - physician shortage

KW - Primary care

KW - racial

KW - segregation

UR - http://www.scopus.com/inward/record.url?scp=84869081579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869081579&partnerID=8YFLogxK

U2 - 10.1111/j.1475-6773.2012.01417.x

DO - 10.1111/j.1475-6773.2012.01417.x

M3 - Article

C2 - 22524264

AN - SCOPUS:84869081579

VL - 47

SP - 2353

EP - 2376

JO - Health Services Research

JF - Health Services Research

SN - 0017-9124

IS - 6

ER -