Poorer, racially diverse neighborhoods more likely to lose health facilities

Poverty and race may play a role in access to healthcare, a new study has found. File photo by Max Pixel
Poverty and race may play a role in access to healthcare, a new study has found. File photo by Max Pixel

May 15 (UPI) -- Neighborhoods with high black and Hispanic or Latino populations are more likely to lose healthcare facilities, potentially making it more difficult to access care, a new study has found.

In research published Friday by JAMA Network Open, the authors observed that these areas had a higher than 50 percent risk for experiencing a healthcare facility closure -- including hospitals, clinics and pharmacies -- than those with predominantly white populations.


Similarly, regions with high levels of poverty, based on findings from the U.S. Census in 2000 and 2010, were 12 percent more likely to see needed health facilities close.

"There is increasing evidence that racial and ethnic disparities in access to healthcare have been reduced for some subgroups after implementation of the Patient Protection and Affordable Care Act," the authors wrote.

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"However, our findings suggest that differential change in geographic presence of health care facilities by neighborhood demographic composition may further widen disparities in population health," they added.

For the study, the authors used business data from the National Establishment Time-Series, a study that examined the presence of and change in ambulatory care facilities, pharmacies and drugstores in census tracts throughout the continental United States between 2000 and 2014.


In general, they found that among 72,246 census tracts included in the analysis, the percentage of non-U.S.-born residents in the population, residents age 75 or older, those living in poverty and population density all increased over the 15-year study period. Additionally, just over 8 percent of the tracts saw their racial or ethnic make-up change, evolving from predominantly white populations to other racial or ethnic compositions.

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Overall, the researchers observed that the presence of ambulatory care facilities increased by about 5 per census tract between 2000 and 2014, while the presence of pharmacies and drugstores increased from a mean of 0.6 per census tract to 0.9 over the same period.

However, they also found that census tracts with predominantly black populations were more than twice as likely than white neighborhoods to lose healthcare facilities between 2000 and 2014.

Similarly, over the same period, Hispanic and Latino areas were 30 percent more likely to see a healthcare facility closure, while ethnically mixed neighborhoods were 53 percent more likely.

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"These trends over time may indicate a need for more targeted efforts to address disparities in access to ambulatory care services," the authors wrote.

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