The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being farther from most services. These patterns likely result from a combination of housing policies that restrict housing opportunities and federal health policies that are based on service provision rather than community need. The findings also illustrate the difficulty of using a single metric-distance-to investigate access to care on a national scale.

Automated summary

Examining the spatial access to healthcare across different regions is crucial for understanding structural inequalities in the United States. This study found that in rural areas, ZIP Code Tabulation Areas (ZCTAs) predominantly inhabited by Black or American Indian/Alaska Native populations were located further away from healthcare services compared to those with a high White population. Conversely, in urban areas, ZCTAs with a high White population were farther from most services. These disparities may result from housing policies that limit opportunities and federal health policies that prioritize service provision over community needs. The study also highlights the limitations of using a single metric, such as distance, to assess healthcare access on a national scale.