An official website of the United States government
Much research has been conducted that demonstrates a link between racial/ethnic residential segregation and health care outcomes. We suggest that minority segregated neighborhoods may have diminished access to organizations and that this differential access may contribute to differences in health care outcomes across communities. We analyze this specifically using the case of pediatric health care provider choice. To examine this association, we estimate a series of multinomial logistic regression models using restricted data with ZIP code level geoidentifiers from the 2011–2012 National Survey of Children’s Health (NSCH). We find that racial/ethnic residential segregation is related to a greater reliance on non-ideal forms of health care, such as clinics, and hospital outpatient departments, instead of pediatric physician’s offices. This association is at least partially attenuated by the distribution of health care facilities in the local area, physician’s offices, and health care practitioners in particular. Additionally, families express greater dissatisfaction with these other forms of care compared to physician’s offices, demonstrating that the lack of adequate health care provision is meaningful for health care outcomes. This study expands the literature by examining how the siting of health organizations has consequences for individuals residing within these areas.
more »
« less
Racial/Ethnic Residential Segregation, Neighborhood Health Care Provision, and Choice of Pediatric Health Care Provider across the United States
Previous work has suggested that minority segregated neighborhoods may have diminished access to health care, and that this may contribute to differences in health outcomes across communities. We analyze this using the case of pediatric provider choice. We estimate a series of multinomial logistic regression models using restricted data from the 2011-2012 National Survey of Children’s Health (NSCH). We find that racial/ethnic residential segregation is related to a greater reliance on non-ideal forms of health care, such as clinics and hospital outpatient departments, instead of pediatric physician’s offices. Additionally, families express greater dissatisfaction with these other forms of care.
more »
« less
- Award ID(s):
- 2147450
- PAR ID:
- 10405780
- Date Published:
- Journal Name:
- American Sociological Association annual meeting
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
Puerto Rico was hit by a category 4 hurricane that severely damaged power, water, and communications systems on the 20th of September 2017. Based on 56 qualitative interviews, this article documents how health care workers created a new ethics of care after Hurricane Maria and engaged in novel forms of health activism to both repair past damage and imagine a different future. Many doctors, nurses, and other health care professionals went to work after the storm treating patients, fixing their workplaces, and resolving logistical problems. Health care workers responded emotionally to the event by finding meaning and purpose in their work, forging a sense of solidarity, and valuing their ability to help others. Our respondents used the term compromiso to describe their determination and sense of purpose, and we borrow this term to label the specific ethics of care generated from their experiences after Maria.more » « less
-
null (Ed.)Background: Despite recently expanded access to health insurance, consumers still face barriers to using their coverage to obtain needed health care. Objective: To examine the characteristics of those who delay or avoid health care due to costs. Methods: Participants were recruited via Amazon MTurk and completed a survey assessing demographic characteristics, financial toxicity, health care minimizer-maximizer tendencies, health insurance knowledge, numeracy, delaying/avoiding any care, and delaying/avoiding six common health care services (three preventive and three nonpreventive services). Validated measures were used when available. Delay/avoidance behaviors were categorized into delaying/avoiding any care, preventive care, and nonpreventive care. Logistic regression models examined 1) financial toxicity, 2) minimizer-maximizer tendencies, 3) numeracy, 4) health insurance knowledge, and 5) knowledge of preventive care coverage separately on three forms of delay/avoidance behaviors, controlling for chronic conditions, insurance status, and/or income where appropriate. Results: Of 518 respondents, 470 did not fail attention-check questions and were used in analyses. Forty-five percent of respondents reported delaying/avoiding care due to cost. Multivariable analyses found that financial toxicity was related to delaying/avoiding any care (odds ratio [OR] = 0.884, P < 0.001), preventive care (OR = 0.906, P < 0.001), and nonpreventive care (OR = 0.901, P < 0.001). A tendency to minimize seeking health care (OR = 0.734, P < 0.001) and lower subjective numeracy (OR = 0.794, P = 0.023) were related to delaying/avoiding any care. General health insurance knowledge (OR = 0.989, P = 0.023) and knowledge of preventive care coverage (OR = 0.422, P < 0.001) were related to delaying/avoiding preventive care. Conclusions: Many people delay or avoid health care due to costs, even when insured. Results suggest that there may be different reasons individuals delay or avoid preventive and nonpreventive care. Findings may inform interventions to educate consumers and support discussions about health care costs to facilitate appropriate health care utilization.more » « less
-
The COVID-19 pandemic increased the rate of mental health disorders, as well as demand for mental health services. It remains unclear, however, the extent to which it impacted access to mental health care. Using data from an audit field experiment, which ran from January to May 2020 and overlapped with the onset of the COVID-19 pandemic, we examine the impact of COVID-19 on access to mental health care appointments in the United States. We find that increased intensity of COVID-19–measured by daily cases, daily fatalities, and weekly excess deaths–is associated with decreased access to mental health care appointments.more » « less
-
Berkowitz_L; Russo_J; Barach_P; Pedrotti_C (Ed.)Only 20% of behavioral health providers use measurement-based care [MBC].1 Two reasons for MBC’s low uptake outcomes are a need for stronger consensus regarding optimal use (in both frequency and consistency) and the absence of a widely utilized data analytics infrastructure. TQIntelligence has built and implemented a measurement-based system for community behavioral health providers, which includes the use of a novel AI-enabled voice algorithm designed to provide psychiatric decision and triaging support to pediatric populations. The success of the implementation and related outcomes varied depending on the organization and the therapist's involvement in the pilot.2 This paper will contribute to the literature on measurement care and its effectiveness. It also challenges the dominant narrative that such systems are too complicated and ineffective in community behavioral health that serve children and adolescents from low-income communities.more » « less
- Free Publicly Accessible Full Text
-
Accepted Manuscript1.0
- Conference Paper:
- The DOI is not currently available.
