Meeting health need, accessing health care: the role of neighbourhood.
Much of what we know about the determinants of access to health care comes from studies undertaken at a large scale, such as between cities, regions/counties/provinces/states and countries. This paper examines local level variations in access to and utilization of health care services across four distinct neighbourhoods in Hamilton, Ontario, Canada. Survey data (n = 1500) were analysed using logistic regression to explore the potential relationships between neighbourhood and health care utilization and unmet health care need. Results show some relationships between neighbourhood of residence and levels of reported utilization as well as unmet need, even when controlling for predisposing, enabling, and need factors (i.e. Age, gender, household composition, income, education, perceived gp visit time) as well as health status. Findings from this empirical study suggest a finer lens is required to examine the mechanisms through which place impacts access to and utilization of care, one that recognizes the roles of compositional, contextual and collective aspects of neighbourhood.
Law
Michael
M
McMaster Institute of Environment and Health, McMaster University, 1280 Main Street West, Hamilton, Ont., Canada L8S 4K1.
Wilson
Kathi
K
Eyles
John
J
Elliott
Susan
S
Jerrett
Michael
M
Moffat
Tina
T
Luginaah
Isaac
I
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D003695:Delivery of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009864:Ontario; D012111:Residence Characteristics