Perceived Quality of Life, Demographics, Civic Participation and Health and Mental Health Care: Another Look at Determinants of Service Access for Los Angeles City Residents

While neighborhoods matter for health, links between collective properties of neighborhoods, e.g., civic participation activities, and outcomes are not well understood. Using the 2008 Leavey Center for the Study of Los Angeles (LA) Presidential Election Exit Poll Survey, determinants of access to health and mental healthcare were investigated using logistic regression, controlling for perception of overall direction of LA (ODL) and direction of neighborhood (DON).

Latinos; Blacks; Asians; females; respondents who participated in union/school board meetings, did not have health insurance (p<.00), received health services in community clinics (p<.03), non-profits (p<.09) or emergency rooms (p<.02), and thought LA was going in the wrong direction/were unsure of direction, were more likely to have difficulty accessing healthcare in LA. Asians were more likely versus Whites to have difficulty, as were Latinos and Blacks. Results were the same for respondents who thought their neighborhood was going in the wrong direction/were unsure of direction, and for those who received healthcare in more settings.

Regardless of perception of ODL, respondents who participated in neighborhood council/neighborhood watch, union/school board meetings, volunteered in community or cared for environment, received health services in non-profits (p<.00) or closed settings (p<.10; e.g., Veteran's Administration, HMO) were more likely to have difficulty accessing mental healthcare. DON was not significant. Results were similar for those who received services in more settings, and had less income.

Comprehensive, targeted community approaches are required to address disparities in care access for various groups, especially for participants in certain civic activities.