Carreon, Daisy (2014). Racial and ethnic residential segregation and health care access.
Does living in a racially and ethnically segregated neighborhood limit access to health care services? In my dissertation, I explore health care access among racial/ ethnic minorities in the United States and whether it is negatively or positively influenced by residential segregation. I conduct three separate analyses using nationally representative data from the National Longitudinal Study of Adolescent Health, Behavioral Risk Factor Surveillance System, Area Resource File, and U.S. Census. I employ multivariate and multilevel models to analyze contextual and individual level data. In study 1, I examine Asian segregation by neighborhood and its relationship to health care access of Asian Americans. Asian segregation has been steadily increasing due in part to the settlement patterns of immigrants. Findings show that the relationship between Asian ethnicity and health care access was modified by the percentage of Asians in a census tract. For Koreans and other Asians, living in a predominately Asian neighborhood increased the probability of getting a yearly medical checkup. For the Chinese and Vietnamese, spatial concentration was associated with worse access to checkups. In study 2, I use multilevel models to investigate the relationship between metropolitan area segregation on individual-level health care access for African Americans. Findings show that when segregation is measured using the isolation index, it is positively associated with having a yearly medical checkup. When using the absolute centralization index, segregation is negatively related to having a yearly checkup. Therefore, the relationship between metropolitan-level segregation and health care access for African Americans depends on the measure of segregation being used. In study 3, I determine which contextual-level characteristics are associated with segregation and number of outpatient visits. Contextual-level characteristics were measured at the county and included the percent of the population unemployed, low educated, and living below poverty-level, as well as health care system variables. The most segregated counties had lowest rates of outpatient visits. For black/white segregation, this relationship remained significant despite adjusting for several county-level characteristics. In contrast, for Hispanic/white segregation and Asian/white segregation, the relationship was explained away by controlling for socioeconomic disadvantage or the number of hospitals, respectively. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Accession Number: 2014-99160-131. Other Journal Title: Dissertation Abstracts International. Partial author list: First Author & Affiliation: Carreon, Daisy; U California, Irvine, US. Release Date: 20141006. Publication Type: Dissertation Abstract (0400). Format Covered: Electronic. Document Type: Dissertation. Dissertation Number: AAI3597426. ISBN: 978-1-303-45499-8. Language: English. Major Descriptor: Health Care Delivery; Neighborhoods. Minor Descriptor: Health Care Services; Risk Factors. Classification: Health & Mental Health Treatment & Prevention (3300). Population: Human (10). Location: US. Methodology: Empirical Study; Quantitative Study.
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