title: The effect of primary care physician supply and income inequality on mortality among blacks and whites in US metropolitan areas.
abstract: OBJECTIVE
  This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites.
  
  
  METHODS
  We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas.
  
  
  RESULTS
  Both income inequality and primary care physician supply were significantly associated with White mortality (P < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality.
  
  
  CONCLUSIONS
  Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins School of Public Health and Hygiene, 624 N Broadway, Room 409, Baltimore, MD 21205-1996, USA. lshi@jhsph.edu
authors.forename: L
authors.initials: L
authors.lastname: Shi
authors.forename: B
authors.initials: B
authors.lastname: Starfield
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D019352:Censuses; D006297:Health Services Accessibility; D006305:Health Status Indicators; D006801:Humans; D007182:Income / Q000145:classification / Q000706:statistics & numerical data*; D009026:Mortality; D015999:Multivariate Analysis; D010821:Physicians, Family / Q000600:supply & distribution*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000145:classification / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*