Access to medical care for low-income persons: how do communities make a difference?

Med Care Res Rev. 2002 Dec;59(4):384-411. doi: 10.1177/107755802237808.


This paper considers the impact of community-level variables over and above the effects of individual characteristics on healthcare access of low-income children and adults residing in large metropolitan statistical areas (MSAs). Further, we rank MSAs' performance in promoting healthcare access for their low-income populations. The individual-level data come from the 1995 and 1996 National Health Interview Survey (NHIS). The community-level variables are derived from multiple public-use data sources. The outcome variable is whether low-income individuals received a physician visit in the past twelve months. The proportion receiving a visit by MSA varied from 63% to 99% for children and from 62% to 83% for adults. Access was better for individuals with health insurance and a regular source of care and for those living in communities with more federally-funded health centers. Children residing in MSA.

MeSH terms

  • Adolescent
  • Adult
  • Catchment Area, Health / economics*
  • Catchment Area, Health / statistics & numerical data
  • Child
  • Child, Preschool
  • Community Health Services / economics
  • Community Health Services / statistics & numerical data*
  • Ethnicity
  • Female
  • Health Care Surveys
  • Health Services Accessibility / economics*
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Odds Ratio
  • Office Visits / economics
  • Office Visits / statistics & numerical data*
  • Poverty Areas
  • Poverty* / ethnology
  • Primary Health Care / economics
  • Primary Health Care / statistics & numerical data*
  • United States