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The effect of primary care physician supply and income inequality on mortality among Blacks and Whites in US metropolitan areas

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  • Shi, L.
  • Starfield, B.

Abstract

Objectives. This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites. Methods. We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas. Results. Both income inequality and primary care physician supply were significantly associated with White mortality (P .10), particularly in areas with high income inequality. Conclusions. Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.

Suggested Citation

  • Shi, L. & Starfield, B., 2001. "The effect of primary care physician supply and income inequality on mortality among Blacks and Whites in US metropolitan areas," American Journal of Public Health, American Public Health Association, vol. 91(8), pages 1246-1250.
    • Handle: RePEc:aph:ajpbhl:2001:91:8:1246-1250_3
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    Cited by:

    1. Chen, Zhuo & Roy, Kakoli & Haddix, Anne C. & Thacker, Stephen B., 2010. "Factors associated with differences in mortality and self-reported health across states in the United States," Health Policy, Elsevier, vol. 94(3), pages 203-210, March.
    2. Horev, Tuvia & Pesis-Katz, Irena & Mukamel, Dana B., 2004. "Trends in geographic disparities in allocation of health care resources in the US," Health Policy, Elsevier, vol. 68(2), pages 223-232, May.
    3. Felipa de Mello-Sampayo, 2020. "Spatial Interaction Model for Healthcare Accessibility: What Scale Has to Do with It," Sustainability, MDPI, vol. 12(10), pages 1-19, May.
    4. Craig Gallet, 2009. "The Determinants of AIDS Mortality: Evidence from a State-Level Panel," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(4), pages 425-436, December.
    5. Susan W. Parker & Joseph Saenz & Rebeca Wong, 2018. "Health Insurance and the Aging: Evidence From the Seguro Popular Program in Mexico," Demography, Springer;Population Association of America (PAA), vol. 55(1), pages 361-386, February.
    6. Stroka-Wetsch, Magdalena A. & Talmann, Anna & Linder, Roland, 2016. "Does competition in the out-patient sector improve quality of medical care? Evidence from administrative data," Ruhr Economic Papers 638, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    7. Simon Burgess & Carol Propper & John A. Rigg, 2005. "Health Supplier Quality and the Distribution of Child Health," CASE Papers 102, Centre for Analysis of Social Exclusion, LSE.
    8. Laura Vallejo-Torres & Stephen Morris, 2018. "Primary care supply and quality of care in England," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(4), pages 499-519, May.
    9. McKinlay, John & Marceau, Lisa, 2008. "When there is no doctor: Reasons for the disappearance of primary care physicians in the US during the early 21st century," Social Science & Medicine, Elsevier, vol. 67(10), pages 1481-1491, November.
    10. Renin Toms & Xiaoqi Feng & Darren J Mayne & Andrew Bonney, 2020. "Role of Area-Level Access to Primary Care on the Geographic Variation of Cardiometabolic Risk Factor Distribution: A Multilevel Analysis of the Adult Residents in the Illawarra—Shoalhaven Region of NS," IJERPH, MDPI, vol. 17(12), pages 1-21, June.
    11. Lung-Chang Chien & Anjali D Deshpande & Donna B Jeffe & Mario Schootman, 2012. "Influence of Primary Care Physician Availability and Socioeconomic Deprivation on Breast Cancer from 1988 to 2008: A Spatio-Temporal Analysis," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-11, April.
    12. Paul Griffin & Hyunji Lee & Christina Scherrer & Julie Swann, 2014. "Balancing investments in federally qualified health centers and Medicaid for improved access and coverage in Pennsylvania," Health Care Management Science, Springer, vol. 17(4), pages 348-364, December.
    13. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    14. Jatrana, Santosh & Crampton, Peter, 2009. "Affiliation with a primary care provider in New Zealand: Who is, who isn't," Health Policy, Elsevier, vol. 91(3), pages 286-296, August.
    15. János Sándor & Anita Pálinkás & Ferenc Vincze & Valéria Sipos & Nóra Kovács & Tibor Jenei & Zsófia Falusi & László Pál & László Kőrösi & Magor Papp & Róza Ádány, 2018. "Association between the General Practitioner Workforce Crisis and Premature Mortality in Hungary: Cross-Sectional Evaluation of Health Insurance Data from 2006 to 2014," IJERPH, MDPI, vol. 15(7), pages 1-12, July.
    16. Helen Lee & Sarah Shea Crowne & Melanie Estarziau & Keith Kranker & Charles Michalopoulos & Anne Warren & Tod Mijanovich & Jill H. Filene & Anne Duggan & Virginia Knox, "undated". "The Effects of Home Visiting on Prenatal Health, Birth Outcomes, and Health Care Use in the First Year of Life: Final Implementation and Impact Findings from the Mother and Infant Home Visiting Progra," Mathematica Policy Research Reports a9626a8d90bf4f01811d0c9d7, Mathematica Policy Research.
    17. Ryvicker, Miriam & Gallo, William T. & Fahs, Marianne C., 2012. "Environmental factors associated with primary care access among urban older adults," Social Science & Medicine, Elsevier, vol. 75(5), pages 914-921.
    18. Shi, Leiyu & Macinko, James & Starfield, Barbara & Politzer, Robert & Xu, Jiahong, 2005. "Primary care, race, and mortality in US states," Social Science & Medicine, Elsevier, vol. 61(1), pages 65-75, July.
    19. Zheng, Hui, 2012. "Do people die from income inequality of a decade ago?," Social Science & Medicine, Elsevier, vol. 75(1), pages 36-45.
    20. Unal, Eda & Chen, Susan E. & Waldorf, Brigitte S., 2007. "Spatial Accessibility Of Health Care In Indiana," Working papers 7329, Purdue University, Department of Agricultural Economics.
    21. Hendrik Jürges & Vincent Pohl, 2012. "Medical guidelines, physician density, and quality of care: evidence from German SHARE data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 635-649, October.
    22. Stroka, Magdalena A., 2021. "Regional variation in the supply of general and medical practitioners and its consequences for inpatient service utilization," Ruhr Economic Papers 877, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

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