The Effect of Primary Care Physician Supply and Income Inequality on Mortality Among Blacks and Whites in US Metropolitan Areas

Leiyu Shi · Barbara H. Starfield

214 citations0/0 files storedAmerican Journal of Public Health

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Health disparities and outcomes Healthcare Policy and Management Public Health and Social Inequalities

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 < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (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.

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References

1996Unhealthy Societies: The Afflictions of Inequality 2000Levels of racism: a theoretic framework and a gardener's tale 1998Socioeconomic Factors, Health Behaviors, and Mortality 1996Inequality in income and mortality in the United States: analysis of mortality and potential pathways 1997Socioeconomic inequalities in morbidity and mortality in western Europe 1997Socioeconomic inequalities in morbidity and mortality in western Europe 1997Socioeconomic determinants of health: Health inequalities: relative or absolute material standards?2017Why are Some People Healthy and Others Not?

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