207327 Comparisons of Health Provider distributions and health/socioeconomic disparities across North Carolina

Sunday, November 8, 2009

Alison Gunn, MPH , Office of Teaching and Learning, UNC School of Medicine, Chapel Hill, NC
David W. Hollar, PhD , UNC School of Medicine, Department of Medicine, Chapel Hill, NC
Considerable research has demonstrated significant health disparities based upon race/ethnicity, disability status, and socioeconomic status across the United States. Disparities are associated with lack of sufficient health care, access to health care facilities, and financial issues. We assess the distribution of health care providers and measures of health disparities across North Carolina. North Carolina county-level statistics were obtained from the UNC Cecil G. Sheps Center for Health Services Research, the North Carolina Center for Health Statistics, U.S. Health Resources Services Administration, and the U.S. Census. Data were analyzed using SPSS and ESRI ArcView Spatial Analyst. Analyses included correlations of variables such as numbers of physicians by specialty, hospitals, SES, indicators of prenatal care and fetal/neonatal/postneonatal/infant/child mortality. As expected, availability of healthcare providers tended to negatively correlate with county socioeconomic status and central health indicators. Counties with high numbers of physicians correlated negatively with age 15-19 pregnancy rate (r = -.245, p < .01) and mothers who smoke while pregnant (r = - .474, p = .000). Healthcare providers correlated positively with county socioeconomic levels (r = .344, p = .000). The results support previous research showing large and increased prevalence of health disparities in underserved areas. Such conditions might increase with the poor economic situation, financial difficulties for rural hospitals, and increased migration into these underserved areas. Policy implications suggest increased regional health center funding including incentives for individuals to pursue general medicine and family practice careers in underserved areas, but past attempts have done little to decrease these disparities.

Learning Objectives:
At the conclusion of this session, the participant will be able to (a) define Health Professions Shortage Areas (HPSA), (b) discuss factors contributing to health professions shortages in urban versus rural areas in large population states/regions, (c) identify barriers to health care distribution in under-served areas, and (d) apply statistical results to child health and disease prevention policy involving health disparities.

Keywords: Access to Care, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead researcher and author of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.