Access to health care for older persons in the United States: personal, structural, and neighborhood characteristics

J Aging Health. 2001 Aug;13(3):329-54. doi: 10.1177/089826430101300302.


Objective: To determine the contributions of personal, structural, and neighborhood characteristics to differential access to health care for older persons in the United States.

Methods: This study used the 1994 National Health Interview Survey, ages 65 and older (n = 12,341), 1990 census block group data, and data on health professional shortage areas. Logistic regression was used to model the probability of problems accessing care.

Results: The likelihood of access problems increased sharply with decreasing gradients of family income and for those lacking private health care insurance. Rural areas and poor areas were at a disadvantage in accessing care, whereas residents of neighborhoods that were homogeneous in ancestral heritage appeared better able to access care.

Discussion: Considering the high association between neighborhood and personal characteristics, it is notable that any neighborhood effects remained after combining them with personal effects.

MeSH terms

  • Aged*
  • Ethnic Groups*
  • Health Services Accessibility*
  • Humans
  • Income
  • Medically Uninsured
  • Models, Theoretical*
  • Poverty
  • Residence Characteristics*
  • Rural Population
  • Social Support
  • Socioeconomic Factors
  • United States