Fewer Pharmacies In Black And Hispanic/Latino Neighborhoods Compared With White Or Diverse Neighborhoods, 2007-15
Fewer Pharmacies In Black And Hispanic/Latino Neighborhoods Compared With White Or Diverse Neighborhoods, 2007-15
复制标题
DOI：
10.1377/hlthaff.2020.01699
复制
发表时间：
2021-05-01
期刊：
影响因子：
9.7
通讯作者：
Qato, Dima Mazen
中科院分区：
文献类型：
--
作者：
Guadamuz, Jenny S.;Wilder, Jocelyn R.;Qato, Dima Mazen
药店的可及性可能是美国城市地区处方药使用和基本医疗保健服务持续存在种族和民族差异的一个被忽视的因素。我们研究了在美国人口最多的30个城市中，基于种族/民族构成的社区药店的可用性和地理可及性。在所有被调查的城市中，我们发现在2007- 2015年期间，黑人和西班牙裔/拉丁裔社区的药店一直少于白色或其他社区。2015年，黑人或西班牙裔/拉丁裔社区的药房沙漠比白色或其他社区多得多，包括那些不是联邦指定的医疗服务不足地区的社区。这些差距在伊利诺伊州芝加哥、加利福尼亚州洛杉矶、马里兰州巴尔的摩、宾夕法尼亚州费城、威斯康星州密尔沃基、得克萨斯州达拉斯、马萨诸塞州波士顿和新墨西哥州阿尔伯克基最为明显。我们还发现，与其他社区相比，黑人和西班牙裔/拉丁裔社区更有可能经历药店关闭。我们的研究结果表明，努力增加获得药物和基本医疗保健服务的机会，包括应对COVID-19，应该考虑制定政策，确保美国城市社区之间公平的药房可及性。这些努力可能包括鼓励药店在药房沙漠中选址的政策，包括提高最有可能关闭的药店的医疗补助和医疗保险报销率。
The accessibility of pharmacies may be an overlooked contributor to persistent racial and ethnic disparities in the use of prescription medications and essential health care services within urban areas in the US. We examined the availability and geographic accessibility of pharmacies across neighborhoods based on their racial/ethnic composition in the thirty most populous US cities. In all cities examined, we found persistently fewer pharmacies located in Black and Hispanic/Latino neighborhoods than White or diverse neighborhoods throughout 2007-15. In 2015 there were disproportionately more pharmacy deserts in Black or Hispanic/Latino neighborhoods than in White or diverse neighborhoods, including those that are not federally designated Medically Underserved Areas. These disparities were most pronounced in Chicago, Illinois; Los Angeles, California; Baltimore, Maryland; Philadelphia, Pennsylvania; Milwaukee, Wisconsin; Dallas, Texas; Boston, Massachusetts; and Albuquerque, New Mexico. We also found that Black and Hispanic/Latino neighborhoods were more likely to experience pharmacy closures compared with other neighborhoods. Our findings suggest that efforts to increase access to medications and essential health care services, including in response to COVID-19, should consider policies that ensure equitable pharmacy accessibility across neighborhoods in US cities. Such efforts could include policies that encourage pharmacies to locate in pharmacy deserts, including increases to Medicaid and Medicare reimbursement rates for pharmacies most at risk for closure.