Actionable Analysis: Toward a Jurisdictional Evaluation of Primary Care Access in the Community Context

J Prim Care Community Health. 2019 Jan-Dec:10:2150132719891970. doi: 10.1177/2150132719891970.

Abstract

Primary care is the foundation of health care systems and has potential to alleviate inequities in population health. We examined multiple measures of adult primary care access, health status, and socioeconomic position at the New York City Council District level-a unit of analysis both relevant to and actionable by local policymakers. The results showed significant associations between measures of primary care access and health status after adjustment for socioeconomic factors. We found that an increase of 1 provider per 10 000 people was associated with a 1% decrease in diabetes rates and a 5% decrease in rates of adults without an influenza immunization. Furthermore, higher rates of primary care providers in high-poverty districts accepted Medicaid and had Patient-Centered Medical Home recognition, increasing constituent accessibility. Our findings highlight the significant contribution of primary care access to community health; policies and resource allocation must prioritize primary care facility siting and provider recruitment in low-access areas.

Keywords: New York City; health equity; health status; primary care access; provider availability; socioeconomic position.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus / epidemiology*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Policy
  • Health Services Accessibility / statistics & numerical data*
  • Health Status Indicators
  • Health Status*
  • Heart Diseases / mortality*
  • Humans
  • Influenza Vaccines / therapeutic use*
  • Male
  • Medicaid
  • Medicare
  • Middle Aged
  • New York City / epidemiology
  • Patient-Centered Care
  • Physicians, Primary Care / supply & distribution
  • Poverty
  • Primary Health Care / statistics & numerical data*
  • Public Health*
  • Socioeconomic Factors
  • United States
  • Young Adult

Substances

  • Influenza Vaccines