• Health services research · Jun 2012

    Review

    Elucidating the role of place in health care disparities: the example of racial/ethnic residential segregation.

    • Kellee White, Jennifer S Haas, and David R Williams.
    • Department of Epidemiology and Biostatistics, University of South Carolina-Arnold School of Public Health, Columbia, SC 29208, USA. kwhite@mailbox.sc.edu
    • Health Serv Res. 2012 Jun 1; 47 (3 Pt 2): 1278-99.

    ObjectiveTo develop a conceptual framework for investigating the role of racial/ethnic residential segregation on health care disparities.Data Sources And SettingsReview of the MEDLINE and the Web of Science databases for articles published from 1998 to 2011.Study DesignThe extant research was evaluated to describe mechanisms that shape health care access, utilization, and quality of preventive, diagnostic, therapeutic, and end-of-life services across the life course.Principal FindingsThe framework describes the influence of racial/ethnic segregation operating through neighborhood-, health care system-, provider-, and individual-level factors. Conceptual and methodological issues arising from limitations of the research and complex relationships between various levels were identified.ConclusionsIncreasing evidence indicates that racial/ethnic residential segregation is a key factor driving place-based health care inequalities. Closer attention to address research gaps has implications for advancing and strengthening the literature to better inform effective interventions and policy-based solutions.© Health Research and Educational Trust.

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