Neighborhood effects on primary care access in Los Angeles
Neighborhood effects on primary care access in Los Angeles
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DOI：
10.1016/j.socscimed.2005.07.029
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发表时间：
2006-03-01
影响因子：
5.4
通讯作者：
Prentice, JC
中科院分区：
文献类型：
--
作者：
Prentice, JC
社区之间的个人健康结果差异很大，最近的研究已经开始研究社区环境如何影响个人健康。一个常见的假设是，医疗保健资源分配不公平限制了贫困社区个人获得医疗保健的机会，导致长期健康状况较差。然而，研究尚未检验邻里环境是否确实影响个人获得初级保健的能力。洛杉矶家庭和社区调查的数据表明，社区之间个人获得初级保健的能力存在显着差异。这种邻里层面的效应不能用居住在邻里的个人组成来解释。研究了邻里环境影响个人获得初级保健能力的四种机制：（1）邻里信息网络，（2）邻里健康行为规范，（3）邻里社会资本和（4）邻里医疗资源。社会资本和医疗保健资源可以显着预测个人获得初级保健的机会。由于初级保健获取的差异可能解释了社区之间个人层面的健康差异，因此旨在改善初级保健获取的政策必须考虑个人和社区的影响。 (c) 2005 Elsevier Ltd. 保留所有权利。
Individual health outcomes differ greatly between neighborhoods, and recent research has begun to examine how neighborhood environment affects individual health. A common hypothesis is that the inequitable distribution of healthcare resources limits access to health care for individuals in disadvantaged neighborhoods, causing poorer long-term health. Yet, research has not examined if neighborhood environment actually affects an individual's ability to access primary care. Data from the Los Angeles Family and Neighborhood Survey suggests there is significant variation between neighborhoods in an individual's ability to access primary care. This neighborhood-level effect is not explained by the composition of individuals living in the neighborhood. Four mechanisms through which neighborhood environment could affect an individual's ability to access primary care are examined: (1) neighborhood information networks, (2) neighborhood health behavior norms, (3) neighborhood social capital and (4) neighborhood healthcare resources. Social capital and healthcare resources significantly predict an individual's primary care access. Since differences in primary care access may explain individual-level health disparities between neighborhoods, policies designed to improve primary care access must account for both individual and neighborhood effects. (c) 2005 Elsevier Ltd. All rights reserved.