Mapping the gaps: How actively do local health departments assess and address gaps in access to healthcare?

Background: Assessing gaps in access to primary care, particularly among underserved populations is an important first step in effectively promoting healthy communities and healthy minds. Proactively assessing the community level service gaps in primary care can fuel policies that will not only guide public health interventions to address primary care gaps in coverage of underserved populations, it will also lead to a long term reduction in healthcare cost. National level studies assessing the extent to which local health departments (LHDs) engage in assessing and addressing gaps in community level primary care are important but non-existent to our knowledge. Objectives/purpose: (a) Examine the level and variation among LHDs in assessing and addressing gaps in medical, dental, and behavioral healthcare within their jurisdictions and implementing strategies to target healthcare needs of underserved populations. (b) Use LHDs GIS shape files to map the gaps. Methods: This study uses data from NACCHO's 2010 National Profile of Local Health Departments (Profile) Survey completed in November of 2010. We will display the geographic variations through maps, using LHD level GIS shape files we have recently developed here at NACCHO. Results: Our preliminary analysis shows that, in the past year, 69 percent of LHDs did assess the gaps in access to services in any of the three categories – medical, dental, behavioral. Fifty-one percent addressed the gaps through direct provision of services in at least one of the three healthcare categories. A larger majority (70%) implemented strategies to increase accessibility of existing services in at least one of the three healthcare categories. An equal proportion (70%) implemented strategies to target healthcare needs of underserved populations. Discussion/conclusion: Examining and geographically displaying variation in LHD's engagement in assessing and addressing gaps in community level access to healthcare have important implications for local public health practice and policy.