Spatial Dimensions of Health Care Access: Using Community-Based Research Approaches

Background: The development and utilization of geographic information system (GIS) technologies and the parallel development of multi-level statistical analysis tools have brought spatial awareness to research on health and health services. These tools provide the basis for consideration of social, economic and health data at a variety of levels to identify spatial patterns. As strong as these tools are, there is need for field-based mixed-methods research, because they provide rich, place-specific information. Often used separately from more technologically complex approaches to research (such as GIS), community-based approaches are compatible and complimentary. Methods: Diverse data collection methods were used in Mississippi Delta and Gulf Coast communities, including key-informant interviews, focus groups and surveys. In each round of data collection, topics addressed barriers to accessing health care, transportation, socioeconomic resources, and demographic characteristics. Results: Research demonstrates that both regions in Mississippi share similarities, but the people and places are different in a number of ways. Differences include racial/ethnic characteristics of the population, level of rural-urban development, economic base, access to transportation, availability of medical services, and people's socioeconomic resources. Discussion: These results point to the importance of working with people at the community level in determining the nature of the challenges they face around accessing health care and identifying solutions that take place into account. Results may be considered in addition to those drawn from GIS and other technologically intensive methods to provide evidence-based guidance to community organizations for focusing services and obtaining funding to provide these services.