title: Public Housing Relocations and Relationships of Changes in Neighborhood Disadvantage and Transportation Access to Unmet Need for Medical Care.
abstract: Cross-sectional research suggests that neighborhood characteristics and transportation access shape unmet need for medical care. This longitudinal analysis explores relationships of changes in neighborhood socioeconomic disadvantage and trans- portation access to unmet need for medical care.
  
  
  
  We analyzed seven waves of data from African American adults (N = 172) relocating from severely distressed public housing complexes in Atlanta, Georgia. Surveys yielded individual-level data and admin- istrative data characterized census tracts. We used hierarchical generalized linear models to explore relationships.
  
  
  
  Unmet need declined from 25% pre-relocation to 12% at Wave 7. Post-relocation reductions in neighborhood disadvantage were inversely associated with reductions in unmet need over time (OR = 0.71, 95% CI = 0.51-0.99). More frequent transportation barriers predicted unmet need (OR = 1.16, 95% CI = 1.02-1.31).
  
  
  
  These longitudinal findings support the importance of neighborhood environments and transportation access in shaping unmet need and suggest that improvements in these exposures reduce unmet need for medical care in this vulnerable population.
authors.forename: Danielle F
authors.initials: DF
authors.lastname: Haley
authors.forename: Sabriya
authors.initials: S
authors.lastname: Linton
authors.forename: Ruiyan
authors.initials: R
authors.lastname: Luo
authors.forename: Josalin
authors.initials: J
authors.lastname: Hunter-Jones
authors.forename: Adaora A
authors.initials: AA
authors.lastname: Adimora
authors.forename: Gina M
authors.initials: GM
authors.lastname: Wingood
authors.forename: Loida
authors.initials: L
authors.lastname: Bonney
authors.forename: Zev
authors.initials: Z
authors.lastname: Ross
authors.forename: Hannah L
authors.initials: HL
authors.lastname: Cooper
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D004777:Environment; D005260:Female; D005845:Georgia; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011638:Public Housing / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000208:ethnology; D014186:Transportation / Q000706:statistics & numerical data*; D035862:Vulnerable Populations