scholarly journals Elucidating the Role of Place in Health Care Disparities: The Example of Racial/Ethnic Residential Segregation

2012 ◽  
Vol 47 (3pt2) ◽  
pp. 1278-1299 ◽  
Author(s):  
Kellee White ◽  
Jennifer S. Haas ◽  
David R. Williams
2018 ◽  
Vol 7 (8) ◽  
pp. 119
Author(s):  
Kathryn Anderson

Previous research has demonstrated the impacts of racial/ethnic residential segregation on access to health care, but little work has been conducted to tease out the mechanisms at play. I posit that the distribution of health care facilities may contribute to poor access to health care. In a study of the Houston area, I examine the association between residential segregation, the distribution of physician’s offices, and two health care access outcomes of having a personal physician, as well as the travel time to their office location. Using the 2010 Health of Houston Survey combined with several census products, I test these relationships in a series of spatial and multilevel models. I find that Black segregation is related to a lower density of physician’s offices. However, I find that this distribution is not related to having a personal physician, but is related to travel times, with a greater number of facilities leading to shorter travel times to the doctor. I also find that Black segregation is positively associated with travel times, and that the distribution of physician’s offices partially mediates this relationship. In sum, these findings suggest that a more equitable provision of health care resources across urban neighborhoods would mitigate some of the negative effects of segregation.


2011 ◽  
Vol 24 (8) ◽  
pp. 904-910 ◽  
Author(s):  
K. White ◽  
L. N. Borrell ◽  
D. W. Wong ◽  
S. Galea ◽  
G. Ogedegbe ◽  
...  

2019 ◽  
Vol 51 (1) ◽  
pp. 22-30 ◽  
Author(s):  
Diana Wu ◽  
Lamercie Saint-Hilaire ◽  
Andrew Pineda ◽  
Danielle Hessler ◽  
George W. Saba ◽  
...  

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d>0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.


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