How Neighborhood Segregation Affects Access to Primary Care Providers in Philadelphia

Despite an ample supply of primary care providers in Philadelphia, “geographic access can vary dramatically, with stark racial differences,” according to research published in Health Affairs. After creating a geocoded database of physicians, nurse practitioners, and physician assistants, the authors examined the ratios of adults per primary care provider across 363 census tracts in city. The number of adults in each census tract was determined through census five-year estimates. The researchers defined “low-access areas” as five or more adjacent census tracts with adult-to-provider ratios among the top 20 percent for the city. This indicates a gap in primary care providers’ coverage. There is also a high degree of racial concentration among Philadelphia’s census tracts. While African Americans account for 42 percent of the city’s population, more than two-thirds of the city’s census tracts have either a very low concentration of African Americans (less than of less than 20 percent of residents) or a very high concentration of African Americans (more than 80 percent of residents).

Key findings:

• Six areas of Philadelphia were found to have low access to primary care providers. These six low-access areas were composed of 63 census tracts, 17 percent of all census tracts studied.
• Thirty-two percent of the census tracts with a high concentration of African American residents were located in an area with low access to primary care. In comparison, just 6.1 percent of census tracts with a low concentration of African American residents were in a low-access area.
• Census tracts with a high concentration of African American residents are 28 times more likely to be in an area with low access to primary health care providers.