Spatial accessibility to pediatric primary care in Philadelphia: an area-level cross sectional analysis

Area of Science:

• Public Health
• Health Services Research
• Pediatrics

Background:

• Pediatric primary care is crucial for child health maintenance.
• Disparities in healthcare access may contribute to racial inequities in health outcomes.
• Neighborhood racial composition is a potential driver of these access differences.

Purpose of the Study:

• To investigate the association between neighborhood racial composition and pediatric primary care accessibility.
• To test the hypothesis that accessibility is lowest in neighborhoods with a higher proportion of non-Hispanic Black residents.

Main Methods:

• Calculated annual ratios of pediatric providers to the pediatric population by census tract in Philadelphia (2008-2016).
• Employed marginal logistic regression to assess the independent association between neighborhood racial composition and primary care access.
• Controlled for neighborhood socioeconomic status, poverty, and public insurance rates.

Main Results:

• Lower pediatric primary care access correlated with greater neighborhood disadvantage.
• After adjusting for disadvantage indicators, the risk of having the lowest access quintile significantly increased with a higher percentage of non-Hispanic Black residents.
• A novel measure of pediatric primary care accessibility revealed persistent disparities.

Conclusions:

• Predominantly non-Hispanic Black neighborhoods exhibit significantly lower pediatric primary care access.
• This disparity in access represents a critical issue in children's healthcare equity.
• Findings underscore the need for targeted interventions to improve access in underserved communities.