Income, race, and preventable hospitalizations: a small area analysis in New Jersey

This research examines the effect of income, race, and cultural factors on preventable hospitalizations, using age and sex-adjusted preventable admissions from 53 contiguous zip codes in New Jersey from 1993 to 1995. Low income was strongly associated with high rates of preventable hospitalization in the study zip codes. Income is likely a proxy for education level, barriers to accessing primary care, and health insurance. A floor effect of income levels was present that may reflect a natural level of preventable hospitalization not affected by income, education, or health insurance status. An independent relationship found between nonwhite race and high preventable hospitalization may be in part the result of delays in seeking care affected by antecedent cultural factors. Removing financial barriers is critical but may be insufficient for reducing preventable hospitalizations if other barriers are not also addressed.