abstract

• This study examined the relationship between racial/ethnic residential segregation and access to health care in rural areas. Data from the Medical Expenditure Panel Survey were merged with the American Community Survey and the Area Health Resources Files. Segregation was operationalized using the isolation index separately for African Americans and Hispanics. Multi-level logistic regression with random intercepts estimated four outcomes. In rural areas, segregation contributed to worse access to a usual source of health care but higher reports of health care needs being met among African Americans (Adjusted Odds Ratio [AOR]: 1.42, CI: 0.96-2.10) and Hispanics (AOR: 1.25, CI: 1.05-1.49). By broadening the spatial scale of segregation beyond urban areas, findings showed the complex interaction between social and spatial factors in rural areas.Copyright © 2016 Elsevier Ltd. All rights reserved.

authors

• Caldwell, Julia T
• Ford, Chandra
• Takahashi, Lois M
• Wallace, Steven P
• Wang, May D

publication date

• December 2017

published in

• Health & place  Journal

keywords

• Adult
• African Americans
• Ethnic Groups
• Female
• Health Services Accessibility
• Hispanic Americans
• Humans
• Male
• Residence Characteristics
• Rural Health Services
• Social Segregation
• Socioeconomic Factors
• Surveys and Questionnaires
• Urban Population

Digital Object Identifier (DOI)

• https://doi.org/10.1016/j.healthplace.2016.11.015

PubMed ID

• 28012312

start page

• 104

end page

• 112

volume

• 43

number