The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care

In the Journal of Primary Care & Community Health, Jane Seymour and colleagues, including LDI senior fellows Daniel Polsky and David Grande, investigate the role of community health centers in reducing racial disparities in access to care. Racial minorities are more likely to live in primary care shortage areas, which is of particular concern given the role of primary care in prevention, chronic disease management, and as an overall entry point to the health care system. The authors surveyed primary care practices in Philadelphia County and neighboring zip codes, identified low-access areas, and analyzed how community health centers influenced spatial accessibility. They found a total of 472 primary care office sites in Philadelphia, with 1,665 FTE primary care providers. Of these, 7.4% sites were CHCs, with 189 FTE primary care providers. The median adult per per primary care provider in Philadelphia was 823:1. Tracts with higher levels of African Americans or Hispanics were more likely to be low-access areas. After adjusting for other factors, census tracts with higher rates of public insurance were more likely to be near a CHC, and tracts close to a CHC were less likely to be in a low-access area. However, this association did not differ by the racial composition of the census tract. The authors conclude that CHCs improve access to care, but that racial minorities remain at risk for a low supply of primary care providers. Efforts to locate CHCs in areas with high levels of public insurance AND high fractions of racial minorities should be considered.