2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

336698
Pharmacy Accessibility and Cost-related Underuse of Prescription Medications Among High Poverty Black and Hispanic Communities on Chicago's South Side


Wednesday, November 4, 2015 : 11:10 a.m. - 11:30 a.m.

Dima Qato, PharmD, MPH, PhD, University of Illinois, Chicago, IL
Jocelyn Wilder, MPH, University of Illinois
Shannon N. Zenk, PhD, MPH, FAAN, College of Nursing, University of Illinois at Chicago, Chicago, IL
Andy Davis, MD, MPH, University of Chicago
Kathy Huff, MPH
Marcus Wolfe, MSW, University of Chicago
Todd Schuble, MSW, University of Chicago
Shane Desautels, MA, New Ways Learning
Stacy Lindau, MD, MAPP, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL
Audio (mp3) recording Recorded Presentation (mp4)
Objective: Policy efforts to reduce the cost of prescription medications in the U.S. have failed to reduce cost-related underuse among Blacks and Hispanics. Affordability is determined not only by the out-of-pocket costs to purchase a prescription medication, but the time and costs associated with accessing pharmacies. The primary objective of this study is to describe pharmacy access, pharmacy utilization patterns and the relationship of these patterns to cost-related underuse among residents of predominantly Black and Hispanic communities on Chicago’s South Side. 

Methods and Results:A population-based probability sample of households located on the South Side of Chicago in 2012/13 was linked with geocoded information on pharmacy type and location.  There were 147 pharmacies in study region. The primary sources for obtaining prescription medications were retail (79%), CHC (14%), or mail order (7%) pharmacy. More than two thirds (69%) of prescription medication users primarily filled their prescriptions at a pharmacy other than the one nearest to their home. The average distance traveled from home to the primary pharmacy was 2.9 miles. The utilization of a community health center (CHC) as the primary pharmacy was associated with significantly longer travel distance (6.3 miles) to primary pharmacy in comparison to the utilization of retail pharmacies. Cost-related underuse was lowest among users of CHC pharmacies independent of distance to primary pharmacy and insurance coverage. 

Conclusions: In predominately black and Hispanic communities, prescription medication users who primarily obtained their medication at a pharmacy located within a CHC where they usually receive care were least likely to report cost-related underuse.

Learning Areas:

Assessment of individual and community needs for health education
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Discuss whether and how accessible heath care resources (specifically pharmacies) in poor minority communities impact utilization and outcomes (underuse of medications) and potentially contribute to health disparities.

Keyword(s): Accessibility, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting research in the field of pharmacy, access to medicines and disparities for over 10 years and have published widely on the topic.
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.

Back to: 5087.0: Community Health and Healthcare Service Delivery