Why Does Place Matter? - The association between residential segregation and racial disparities in health is well documented. Our prior research at the HCHDS extended the research literature by finding an association between residential segregation and healthcare utilization. Using data from the 2006 Medical Expenditure Panel Survey, we found that persons living in minority communities had less access to physician care, and used fewer physician, non-physician, mental health, cardiac and diabetes services compared to persons living in majority white communities. However, beyond the racial and ethnic composition of communities little is known about the mechanisms that govern these associations. This project seeks to describe the relationship between "place" and racial disparities in healthcare use. We want to advance our research by understanding the dynamics of "place". What are the characteristics of minority communities that produce disparities in health and healthcare use? This research project proposes three specific aims to answer the question: Why does place matter? Specific Aim 1) To determine if the association between the racial/ethnic composition of neighborhoods and healthcare use can be explained by variations in healthcare provider availability.
Specific Aim 2) To examine whether the healthcare use of individuals changes as the racial/ethnic composition of their census tracts changes over time.
Specific Aim 3) To determine whether the level of private investment in a community impacts health and healthcare utilization.

Public Health Relevance

Previous research has found that residential segregation is associated with healthcare use, i.e., place does matter. Our previous study showed that persons living in minority communities had lower access to physician care, and used fewer physician, non-physician, and mental health services compared to persons living in majority white communities. Now we would like to extend this research by understanding why place matters for health and healthcare utilization.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Comprehensive Center (P60)
Project #
5P60MD000214-13
Application #
8663612
Study Section
Special Emphasis Panel (ZMD1-RN)
Project Start
Project End
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
13
Fiscal Year
2014
Total Cost
$66,216
Indirect Cost
$25,342
Name
Johns Hopkins University
Department
Type
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
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