Geographic Disparities in Access to Agencies Providing Income-Related Social Services.
Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.
University of California School of Medicine, 505 Parnassus Avenue, San Francisco, CA, 94103, USA.
Scott R
SR
Bauer
Division of Clinical Research, Boston Children's Hospital, Boston, USA.|Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.|Department of Pediatrics, Harvard Medical School, Boston, USA.
Michael C
MC
Monuteaux
Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. eric.fleegler@childrens.harvard.edu.|Department of Pediatrics, Harvard Medical School, Boston, USA. eric.fleegler@childrens.harvard.edu.
Eric W
EW
Fleegler
D001900:Boston; D040362:Geographic Information Systems; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D012307:Risk Factors; D012947:Social Work / Q000191:economics / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data
Geographic information system (GIS); Health services geographic accessibility; Poverty; Social determinants of health