title: Expanding federal funding to community health centers slows decline in access for low-income adults.
abstract: OBJECTIVE
  To identify the impact of the Health Center Growth Initiative on access to care for low-income adults.
  
  
  METHODS
  Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008).
  
  
  METHODS
  We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage.
  
  
  METHODS
  We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions.
  
  
  RESULTS
  Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults.
  
  
  CONCLUSIONS
  Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period.
authors.affiliation: Health Policy Center, The Urban Institute, Washington, DC.
authors.forename: Stacey
authors.initials: S
authors.lastname: McMorrow
authors.forename: Stephen
authors.initials: S
authors.lastname: Zuckerman
mesh_terms: D000328:Adult; D003151:Community Health Centers / Q000191:economics*; D005260:Female; D005380:Financing, Government / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D014481:United States; D055815:Young Adult
keywords: Health centers; access to care; primary care; safety net