Why Place Matters

项目摘要 地点对健康很重要。居住隔离与较高的死亡率、较差的获得机会和较低的 少数种族/族裔的保健质量。然而，很多关于为什么地方仍然未知 事项.特别是，基于地点的特征，如农村和收入隔离， 保健方面的差异没有得到很好的研究。更好地理解这些基于地点的特征如何交叉 由于种族-民族的居住隔离会影响医疗保健的获得，质量和差距可能会 这对于制定关注当地情况的干预措施和政策解决方案至关重要。 我们在Why Place Matters研究项目下的研究发现，少数民族社区的居民 获得初级保健和专家服务，减少使用医生、非医生和心理健康服务 与大多数白色社区的居民相比。利用全面的数据资源 通过我们的研究计划开发，我们的团队将进行二次分析，以探索 有几个重要的但研究不足的地方特点对保健差距。具体而言，我们的研究将 研究：1）农村，2）收入隔离，3）语言隔离对少数民族健康的影响 护理的获得和利用。我们将研究不同种族-民族群体的这些关系（例如，黑人 西班牙裔）和种族少数民族群体与白人之间的护理差异。我们还将测试 供应商的可用性或质量调解这些关系。最后，我们将探讨这些因素之间的相互作用。 社区特征与种族-民族构成对黑人卫生保健获得和利用的影响。 将使用描述性、双变量、分层分析和回归模型，包括多水平模型， 检查每个地方特征与地区级医疗保健资源可用性和质量的关系 以及少数民族医疗保健的获取和使用。 这个项目将继续研究为什么地方重要，以了解地方对健康的作用 护理差异。更好地了解生活在复杂环境中的少数群体的经历 具有不同的特权或劣势组合的背景可以为准确定位的开发提供信息。 卫生宣传或干预措施。该项目适合社会文化和医疗保健系统 NIMHD少数民族健康和健康在个人和社区层面的影响 差异研究框架。

PROJECT SUMMARY Place matters for health. Residential segregation has been linked to higher mortality, poorer access and lower quality of health care for racial/ethnic minorities. However, much remains unknown about the why place matters. In particular, the role of place-based characteristics such as rurality and income segregation in health care disparities is not well studied. A better understanding of how these place-based characteristics intersect with residential segregation by race-ethnicity to influence health care access, quality and disparities could be essential for developing interventions and policy solutions that are attentive to the local context. Our studies under the Why Place Matters research program found residents of minority communities had lower access to primary care and specialists and reduced use of physician, non-physician and mental health services compared to residents of majority white communities. Leveraging the comprehensive data resources developed through our research program, our team will conduct secondary analyses to explore the role of several important, but understudied, place characteristics on health care disparities. Specifically, our study will examine the associations of: 1) rurality, 2) income segregation, and 3) language segregation on minority health care access and utilization. We will examine these relationships for different race-ethnic groups (e.g., Blacks, Hispanics) and on care disparities between race-ethnic minority groups with Whites. We will also test whether provider availability or quality mediates these relationships. Finally, we will explore the interaction of these community characteristics with race-ethnic composition on health care access and utilization of Blacks. Descriptive, bivariate, stratified analysis, and regression models, including multilevel models will be used to examine the relationship of each place characteristic with area-level healthcare resource availability and quality and with minority health care access and use. This project will continue the research program Why Place Matters to understand the role of place on health care disparities. A better understanding of the experiences of minorities living in complex environmental contexts, with varying mix of privileges or disadvantages, could inform the development of accurately targeted health communications or interventions. This project fits within sociocultural and healthcare system domains at both individual and community levels of influence of the NIMHD Minority Health and Health Disparities Research Framework.