May 12, 2020

One’s geographic proximity to healthcare and healthcare facilities is linked to increased utilization for preventive care and improved health outcomes for certain chronic conditions. The association between proximity to healthcare facilities and improved disease management and population health has been documented, but little is known about small-area healthcare environments and how the presence of healthcare facilities have changed over time during recent health system and policy change. Research over a 15-year period, using data from the National Establishment Time-Series 2000-2014, found differential change in the presence of healthcare facilities across neighborhoods, with more disadvantaged neighborhoods losing or never having facilities during this time period. 

Research led by Jana A. Hirsch, PhD, MES, assistant research professor at the Urban Health Collaborative, at the Dornsife School of Public Health at Drexel, along with her research team found evidence to suggest that the higher poverty a neighborhood was in, the higher odds of losing vital healthcare facilities.  The research found tracts classified as predominantly non-Hispanic Black, Hispanic/Latino, or racially mixed in 2000 were more likely to never have any or to lose ambulatory care facilities between 2000-2014 than predominantly non-Hispanic white tracts. 

The research team also examined how ongoing shifts in neighborhood poverty and composition related to the presence of healthcare facilities over time. Among neighborhoods with an increasing concentration of poverty, healthcare needs may be growing as well but the consistent presence of healthcare facilities is less likely. In terms of a possible solution, the research team suggests to not only monitor the distribution of these healthcare facilities, but also to protect access to required healthcare resources in those communities. 

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