Elucidating the role of place in health care disparities: the example of racial/ethnic residential segregation

Health Serv Res. 2012 Jun;47(3 Pt 2):1278-99. doi: 10.1111/j.1475-6773.2012.01410.x. Epub 2012 Apr 19.

Abstract

Objective: To develop a conceptual framework for investigating the role of racial/ethnic residential segregation on health care disparities.

Data sources and settings: Review of the MEDLINE and the Web of Science databases for articles published from 1998 to 2011.

Study design: The extant research was evaluated to describe mechanisms that shape health care access, utilization, and quality of preventive, diagnostic, therapeutic, and end-of-life services across the life course.

Principal findings: The framework describes the influence of racial/ethnic segregation operating through neighborhood-, health care system-, provider-, and individual-level factors. Conceptual and methodological issues arising from limitations of the research and complex relationships between various levels were identified.

Conclusions: Increasing evidence indicates that racial/ethnic residential segregation is a key factor driving place-based health care inequalities. Closer attention to address research gaps has implications for advancing and strengthening the literature to better inform effective interventions and policy-based solutions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Emigration and Immigration
  • Ethnicity*
  • Health Services / statistics & numerical data*
  • Health Services Accessibility / organization & administration
  • Health Services Research / methods
  • Health Status
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Prejudice
  • Racial Groups*
  • Research Design
  • Residence Characteristics*
  • Socioeconomic Factors
  • Sociology, Medical