Racial Residential Segregation and the Distribution of Auxiliary Health Care Practitioners Across Urban Space

Abstract

Abstract Scholarship has demonstrated important consequences of segregation on health and health care outcomes, yet the mechanisms behind this association remain poorly understood. Several recent studies have shown inequities in the distribution of a wide variety of health-related organizations across urban neighborhoods, which may account for some portion of this negative health association. Though, within this literature, relatively little attention has been given to the distribution of health care facilities in particular. Here, I consider how segregation is related to the distribution of several auxiliary health care practitioners in a series of spatial regression models of zip codes across the United States using data from the 2010 US Census and County Business Patterns (CBP). I find that both Black and Latino segregation is negatively related to the density of a number of auxiliary health care practitioners, including mental health providers, dentists, physical/occupational/speech therapists, chiropractors, optometrists, podiatrists, and miscellaneous health care practitioners. However, this association is reduced (in certain instances to non-significance) with the inclusion of socioeconomic indicators, chiefly the percent of college educated individuals and the unemployment rate of the zip code. This is association is reduced for both Black and Latino segregation, with a larger reduction in the size of the effects for Latino segregation. This research suggests that segregation plays an important role in the distribution of health care facilities, but that policy and public health interventions should focus on the intersection between racial residential segregation and socioeconomic considerations.