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.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Comprehensive Center (P60)
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Special Emphasis Panel (ZMD1-RN)
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Johns Hopkins University
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LaVeist, Thomas A; Thorpe Jr, Roland J; Pierre, Geraldine et al. (2014) THE RELATIONSHIPS AMONG VIGILANT COPING STYLE, RACE, AND DEPRESSION. J Soc Issues 70:241-255
Smolen, J R; Thorpe Jr, Roland J; Bowie, J V et al. (2014) Health insurance and chronic conditions in low-income urban whites. J Urban Health 91:637-47
Wilson-Frederick, Shondelle M; Thorpe Jr, Roland J; Bell, Caryn N et al. (2014) Examination of race disparities in physical inactivity among adults of similar social context. Ethn Dis 24:363-9
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Bower, Kelly M; Thorpe Jr, Roland J; LaVeist, Thomas A (2013) Perceived racial discrimination and mental health in low-income, urban-dwelling whites. Int J Health Serv 43:267-80

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