The health care of poor persons living in wealthy areas.

This paper describes the problems inherent in targeting new health care initiatives to disadvantaged communities rather than to disadvantaged persons in the 100 wealthiest counties in the United States. The barriers to care experienced by such persons are generally comparable to those of other poor persons. Deprivations in access to care appear to be caused by poverty per se and not by the characteristics of the places in which the poor live. It is suggested that per capita income not be used as a criterion for the allocation of health care resources. The actual number of poor persons in a geographic area is a better criterion for determining the need for public health care programs.