Pharmacy deserts: More than where pharmacies are.

Area of Science:

• Public Health
• Health Services Research
• Geographic Information Systems (GIS)

Background:

• Geographic access to pharmacies is a significant factor in US healthcare disparities.
• Previous studies identified pharmacy deserts but often relied on distance, not travel time, as a limitation.
• Pharmacy deserts are prevalent even in major metropolitan areas.

Purpose of the Study:

• To assess pharmacy deserts using travel time, not just distance.
• To incorporate private vehicle and public transportation access for a comprehensive analysis.
• To identify disparities in pharmacy access beyond simple geographic location.

Main Methods:

• Collected pharmacy data from the National Provider Identifier database and neighborhood data from census records for four major US cities.
• Utilized open-source routing engines to evaluate pharmacy access based on travel time.
• Defined pharmacy deserts using both distance and travel time metrics, including sensitivity analysis for travel time variations.

Main Results:

• Distance-based analysis identified 14.4% of neighborhoods as pharmacy deserts.
• Travel time analysis, incorporating car and public transport, revealed significant disparities, with predominantly white neighborhoods disproportionately underserved.
• Reducing travel time thresholds drastically increased the number of identified pharmacy deserts, primarily in non-predominantly white neighborhoods.

Conclusions:

• Pharmacy access disparities are multifaceted, extending beyond geographic proximity to include transportation accessibility.
• Addressing public transportation access is crucial for reducing pharmacy deserts.
• Rethinking pharmacy desert definitions with travel time and transportation modes offers a more accurate picture of health equity.