Changes in healthcare access and utilization among participants in a public housing relocation program in Atlanta, Georgia

Abstract

Using survey data from participants in a public housing relocation program in Atlanta, Georgia, we examine post-relocation changes in healthcare access (having a usual source of care, having an unmet need) and utilization (receiving a medical exam). Although participants moved to safer, less impoverished neighborhoods, some participants experienced improvements in access and utilization whereas others experienced declines. The supply of healthcare providers in the new neighborhood and having health insurance were associated with improvements in access for this population. Future relocation efforts may seek to assist individuals with choosing a new neighborhood that has accessible healthcare resources for low-income populations.

Keywords: Health insurance; Healthcare access; Neighborhood poverty; Public housing relocation.

Figure 1

Adjusted percentage of adult participants in public housing relocation program that experienced changes in healthcare access and utilization between baseline and follow-up, by physician supply Note: Results come from multinomial regression models adjusted for age, gender, baseline health status, insurance status at follow-up, neighborhood enabling characteristics at follow-up, and distance moved. Significance refers to the difference in the adjusted percentage of participants that experienced an improvement in access/utilization, by physician supply at follow-up. *p<0.05. ^‡ N=134, ^± N=139 African American adult participants in public housing relocation program.

Figure 2

Adjusted percentage of adult participants in public housing relocation program that experienced changes in healthcare access between baseline and follow-up, by individual health insurance status Notes: Results come from multinomial regression models adjusted for age, gender, baseline health status, insurance status at follow-up, neighborhood enabling characteristics at follow-up, and distance moved. Significance refers to the difference in the adjusted percentage of participants that experienced an improvement or decline in access, by insurance status at follow-up. ***p<0.001. ^‡ N=137, ^± N=134 African American adult participants in public housing relocation program. For the measure of unmet need, participants who reported an unmet need at baseline, but none at follow-up, were classified as having an improvement in access.