Does neighborhood socioeconomic environment affect health care access among hypertensive Black men?

Background: Black men are at higher risk of premature death from hypertension compared to White men, possibly due to less healthcare access.  Neighborhood socioeconomic environments may have implications for accessing care. We sought to determine whether neighborhood socioeconomic  factors are related to having a regular source of care among urban Black men.

Methods: We used individual-level socioeconomic status (SES) and health care access data collected from 674 Black men age >50 at barbershops across New York City (NYC) linked to neighborhood-level socio-demographic data (% of zip code living below the poverty level) from the 2011 American Community Survey by zip code to investigate the relationship between neighborhood-level socioeconomic factors and having a regular source of care.

Results: Over 83% lived in high poverty areas (median income < state poverty level). Median annual household income was $10,800, 22% were uninsured, and 73% reported a regular place of care. Living in a high poverty area was positively associated with having a regular place of care (OR=1.92, p<0.01) and negatively associated with being uninsured (OR=0.61, p <0.01).  Individual SES was not related to having a regular place of care or insurance status.

Conclusion: Despite the potential for fewer resources in high poverty neighborhoods, Black men living in these areas were more likely to have a regular place for care and to be insured than those living in lower poverty areas.  This finding may indicate an important role for the safety net health care system in NYC for the most underserved Black men.