Access to medical care for low-income persons: how do communities make a difference?

This paper considers the impact of community-level variables over and above the effects of individual characteristics on healthcare access of low-income children and adults residing in large metropolitan statistical areas (MSAs). Further, we rank MSAs' performance in promoting healthcare access for their low-income populations. The individual-level data come from the 1995 and 1996 National Health Interview Survey (NHIS). The community-level variables are derived from multiple public-use data sources. The outcome variable is whether low-income individuals received a physician visit in the past twelve months. The proportion receiving a visit by MSA varied from 63% to 99% for children and from 62% to 83% for adults. Access was better for individuals with health insurance and a regular source of care and for those living in communities with more federally-funded health centers. Children residing in MSA.