Catalano Giovanni, Woldesenbet Selamawit, Pawlik Timothy M
Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, Ohio, United States of America.
Department of Surgery, University of Verona, Verona, Italy.
PLoS One. 2025 Aug 11;20(8):e0330027. doi: 10.1371/journal.pone.0330027. eCollection 2025.
Recent pharmacy closures across the US has increased the number of communities characterized as "pharmacy deserts." Residential segregation and structural economic disinvestment including the digital divide may exacerbate inequities related to pharmacy access.
In this cross-sectional study, pharmacy deserts were defined at the census tract level and their distribution was analyzed relative to the digital divide index (DDI) and residential redlining using multivariate logistic regression.
Overall, 3,105 (3.72%) census tracts were classified as pharmacy deserts comprising more than 10 million inhabitants (n = 10,215,249). Pharmacy deserts were more often Black (n = 398, 13% vs. n = 6142, 7.6%), Hispanic (n = 597, 19.0% vs. 7662, 9.5%), or American Indian and Alaska Native (n = 82,14.0% vs. n = 113, 0.1%) segregated communities (all p < 0.001). Census tracts with a high DDI (OR 6.94, 95%CI 5.82-8.32; p < 0.001; E-value = 4.70) had a higher likelihood of being a pharmacy desert versus low DDI areas. Furthermore, census tracts experiencing high residential redlining had a twofold increased risk of being pharmacy deserts (OR 2.18, 95%CI 1.90-2.50; p < 0.001; E-value = 2.31).
Understanding how socioeconomic and infrastructure factors influence access to pharmacies is crucial to reduce health inequities. Efforts should be made to ensure equitable access to pharmacy services, especially for underserved populations in both rural and urban settings.
近期美国各地的药房关闭增加了被称为“药房荒漠”的社区数量。居住隔离以及包括数字鸿沟在内的结构性经济投资不足可能会加剧与药房可及性相关的不平等。
在这项横断面研究中，在人口普查区层面定义药房荒漠，并使用多变量逻辑回归分析其相对于数字鸿沟指数（DDI）和居住红线划分的分布情况。
总体而言，3105个（3.72%）人口普查区被归类为药房荒漠，涉及超过1000万居民（n = 10215249）。药房荒漠所在社区更常为黑人社区（n = 398，占13%，而n = 6142，占7.6%）、西班牙裔社区（n = 597，占19.0%，而n = 7662，占9.5%）或美国印第安人和阿拉斯加原住民社区（n = 82，占14.0%，而n = 113，占0.1%）（所有p < 0.001）。与低数字鸿沟指数地区相比，高数字鸿沟指数的人口普查区成为药房荒漠的可能性更高（比值比6.94，95%置信区间5.82 - 8.32；p < 0.001；E值 = 4.70）。此外，经历高居住红线划分的人口普查区成为药房荒漠的风险增加两倍（比值比2.18，95%置信区间1.90 - 2.50；p < 0.001；E值 = 2.31）。
了解社会经济和基础设施因素如何影响药房可及性对于减少健康不平等至关重要。应努力确保公平获得药房服务，特别是为农村和城市地区的弱势群体提供服务。
