Neighborhood Socioeconomic Disadvantage and Access to Healthcare

James B. Kirby, U.S. Department of Health and Human Services (DHHS)
Toshiko Kaneda, Population Council

Most research on access to healthcare focuses on individual-level characteristics such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed care, however, has not received much attention. We address this gap in the literature by examining how neighborhood socioeconomic disadvantage is associated with access to healthcare. We find that living in disadvantaged neighborhoods reduces the likelihood of having a usual source of care and obtaining recommended preventive care services, while it increases the likelihood of having unmet medical need. These associations are not explained by the supply of healthcare in neighborhoods. Furthermore, though controlling for individual-level characteristics reduces the association between neighborhood disadvantage and access to healthcare, a significant association remains. These findings suggest that focusing exclusively on barriers to care at the individual-level may miss important community-level factors that prevent individuals from obtaining the care they need.