'Health care deserts' more common in black neighborhoods
New research into "health care deserts" finds that primary-care physicians are especially hard to find in predominantly Black and/or low-income Hispanic metropolitan neighborhoods.
"What this says to us is that we really need to encourage physicians to locate in these areas," said study lead author Darrell J. Gaskin, Ph.D., deputy director of the Hopkins Center for Health Disparities Solutions at Johns Hopkins Bloomberg School of Public Health.
Research suggests that minorities, the poor, people in inner cities and rural areas, and the uninsured are more likely to not have a regular source of medical care. Primary-care physicians are crucial because they're "our first line of defense in the health-care system," Gaskin said. "They deliver most of our preventive and routine services in terms of checkups and initial acute-care services and do the initial diagnosis to let patients know if they need a higher level of care."
In the new study, published in the latest issue of Health Services Research, Gaskin and colleagues examined U.S. Census and American Medical Association data from 2000 and 2006 to determine which zip codes in U.S. metropolitan areas - which can include rural neighborhoods - had a shortage of primary-care physicians, defined as one physician for 3500 or more people, or no physician at all.
After controlling for other demographic and economic factors, 25.6 percent of Blacks and 24.3 of Hispanics lived in zip codes with few or no primary-care physicians, compared to 9.6 percent of Asian and 13.2 percent of Whites. Zip codes that were identified with mostly Black or Hispanic residents were more likely to have a shortage of primary care physicians, however the disparity disappeared for Hispanics after controlling for socioeconomic factors.
Interestingly, segregation of Asians, and to a lesser extent, certain groups of Hispanics, was positively associated with the availability of a primary care physician. Gaskin speculated that shortages in Asian and some Hispanic neighborhoods may be averted by the immigration of foreign-trained doctors. They might be looking for places where patients speak their languages, he said.
As for black neighborhoods, he said racism and bigotry may not be a major factor for physicians as they make decisions about where to locate their practices. It may be difficult to financially sustain a practice in black neighborhoods because higher proportions of black patients are uninsured or covered by Medicaid.
Stephen B. Thomas, Ph.D., director of the University of Maryland Center for Health Equity, praised the quality of the study and said that "in many ways, it confirms that being black matters."
He agreed with Gaskin that the poverty of potential black patients plays a major role in the creation of areas with few primary care doctors. "You cannot make a living as a solo practitioner, particularly in primary care, if you're serving a population that lacks the ability to pay."
Gaskin said solutions include expanding health insurance coverage to the uninsured and increasing doctors reimbursement from the government to relocate to neighborhoods with physician shortages. Now, treating the poor, who use Medicaid for medical expenses, can be a costly proposition for a physician.
"You can't pay physicians less for a service under Medicaid and expect them to want to practice in that kind of area," Gaskin said. "We're talking about areas where doctors won't be able to practice because they just can't sustain themselves."
More information: Gaskin D, et al. 2012. Residential Segregation and the Availability of Primary Care Physicians. Health Services Research Journal In Press
Provided by Health Behavior News Service
- Minorities, whites get equal care in hospitals Mar 11, 2008 | not rated yet | 0
- Racial and ethnic disparities detected in patient experiences Oct 28, 2008 | not rated yet | 0
- Rising barriers to primary care send many Americans to the emergency department Aug 09, 2011 | not rated yet | 0
- Study: Doctors differ in how best to care for America's 12 million cancer survivors Jul 25, 2011 | not rated yet | 0
- Nearly half of physician practices do not meet national standards for 'medical homes' Oct 18, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
Calorie information in fast food restaurants used by 40 percent of 9-18 year olds when making food choices
A new study published online today (Thursday) in the Journal of Public Health has found that of young people who visited fast food or chain restaurants in the U.S. in 2010, girls and youth who were obese were more likely ...
Health 7 hours ago | not rated yet | 0
(HealthDay)—Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published ...
Health 9 hours ago | not rated yet | 0
(AP)—The Obama administration says more doctors and hospitals are embracing technology as adoption of computerized medical records reaches a "tipping point" in America.
Health 10 hours ago | not rated yet | 0
Johns Hopkins researchers report that hospitals may be reaping enormous income for patients whose hospital stays are complicated by preventable bloodstream infections contracted in their intensive care units.
Health 11 hours ago | not rated yet | 0
A University of Illinois researcher says that the cornerstone of our efforts to alleviate food insecurity should be to encourage more people to participate in the Supplemental Nutrition Assistance Program (SNAP) "because ...
Health 11 hours ago | not rated yet | 0
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
2 hours ago | not rated yet | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
13 hours ago | 4.9 / 5 (7) | 0 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
13 hours ago | 4.5 / 5 (2) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
10 hours ago | 5 / 5 (2) | 2 |
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
10 hours ago | 4 / 5 (2) | 0 |
A new approach for immunizing against influenza elicited a more potent immune response and broader protection than the currently licensed seasonal influenza vaccines when tested in mice and ferrets. The vaccine ...
11 hours ago | not rated yet | 0 |