Access to usual source of care by race and income in ten urban areas

In terms of less access to private sources of care (as distinguished from hospital-public clinics) and longer travel time to usual source of care, poverty areas are at a disadvantage. Within the ten areas studied, the poor have less access than the nonpoor, with access differences even greater between the races than between income groups. Blacks generally have less than whites when income differences are taken into account. Both the type of usual source of care and travel time appear to be related to differential utilizations of ambulatory care resources: persons reporting private sources of care and persons with shorter travel time to their usual source of care tend to make more physician visits in a year. Mechanisms for public financing of health care will not likely alleviate the problems of inaccessibility presented by poverty areas. It is in these areas of low access that public responsibility to organize and locate facilities will continue even after the advent of a fairly comprehensive payment mechanism for health care among the poor.