公共住房搬迁以及邻里劣势和交通便利性变化与未满足的医疗需求之间的关系。
Public Housing Relocations and Relationships of Changes in Neighborhood Disadvantage and Transportation Access to Unmet Need for Medical Care.
作者信息
Haley Danielle F, Linton Sabriya, Luo Ruiyan, Hunter-Jones Josalin, Adimora Adaora A, Wingood Gina M, Bonney Loida, Ross Zev, Cooper Hannah L
出版信息
J Health Care Poor Underserved. 2017;28(1):315-328. doi: 10.1353/hpu.2017.0026.
INTRODUCTION
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.
METHODS
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.
RESULTS
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).
CONCLUSION
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.
引言
横断面研究表明，邻里特征和交通便利性会影响未满足的医疗需求。这项纵向分析探讨了邻里社会经济劣势和交通便利性的变化与未满足的医疗需求之间的关系。
方法
我们分析了来自佐治亚州亚特兰大市从严重贫困的公共住房小区搬迁出来的非裔美国成年人（N = 172）的七轮数据。调查产生了个体层面的数据以及以普查区为特征的行政数据。我们使用分层广义线性模型来探究这些关系。
结果
未满足的需求从搬迁前的25%下降到第七轮时的12%。搬迁后邻里劣势的减少与未满足需求随时间的减少呈负相关（OR = 0.71，95% CI = 0.51 - 0.99）。更频繁的交通障碍预示着未满足的需求（OR = 1.16，95% CI = 1.02 - 1.31）。
结论
这些纵向研究结果支持了邻里环境和交通便利性在塑造未满足需求方面的重要性，并表明改善这些因素可以减少这一弱势群体未满足的医疗需求。
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