Access to health care for older persons in the United States: personal, structural, and neighborhood characteristics.
OBJECTIVE
To determine the contributions of personal, structural, and neighborhood characteristics to differential access to health care for older persons in the United States.


METHODS
This study used the 1994 National Health Interview Survey, ages 65 and older (n = 12,341), 1990 census block group data, and data on health professional shortage areas. Logistic regression was used to model the probability of problems accessing care.


RESULTS
The likelihood of access problems increased sharply with decreasing gradients of family income and for those lacking private health care insurance. Rural areas and poor areas were at a disadvantage in accessing care, whereas residents of neighborhoods that were homogeneous in ancestral heritage appeared better able to access care.


CONCLUSIONS
Considering the high association between neighborhood and personal characteristics, it is notable that any neighborhood effects remained after combining them with personal effects.
Auchincloss
A H
AH
National Center for Health Statistics, Center for Disease Control and Prevention, USA. aauch@juno.com
Van Nostrand
J F
JF
Ronsaville
D
D
D000368:Aged; D005006:Ethnicity; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D017057:Medically Uninsured; D008962:Models, Theoretical; D011203:Poverty; D012111:Residence Characteristics; D012424:Rural Population; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States