Availability of federally qualified health centers in Latinx communities

Federally Qualified Health Centers (FQHCs) are a key source of safety net healthcare in the U.S., and much of the patient population of FQHCs identifies as racial or ethnic minorities. Latinx individuals are overrepresented in the patient population of FQHCs, and this group exhibits increasing geographic diversity in places of residence over time. This study investigates associations between FQHC availability and two Latinx community attributes: Latinx destination type and Latinx-White segregation. Prior research shows that established Latinx destinations have more FQHC availability than "new" destinations, and higher levels of residential segregation of non-White groups from Whites is also associated with a higher supply of FQHCs. However, no prior study has assessed whether Latinx-White segregation explains or moderates associations between Latinx destinations and FQHC supply and access. Using multiple national data sources, we investigate the county-level relationship between Latinx destination type, Latinx-White residential segregation (dissimilarity and isolation indices), and the supply of FQHCs by 2022. In fully adjusted models controlling for Latinx isolation, the likelihood of having any FQHC in the county and the predicted total count of FQHCs in the county did not differ significantly between new and established destinations. In contrast, the Latinx-White dissimilarity index and Latinx isolation were consistent predictors of FQHC availability across counties. Latinx isolation attenuated differences in FQHC availability between new and minor and established destinations in the predicted count of FQHCs in the county. These results indicate that county-level FQHC availability is more consistently associated with Latinx-White segregation indicators than with Latinx destinations.