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. 2023 Jan-Dec:60:469580221135953.
doi: 10.1177/00469580221135953.

A Novel Approach to Locating Community Clinics to Promote Health Care Accessibility and Reduce Health Disparities in Baltimore, Maryland

Caitlin DeClercq  1 , Mohammad Gharipour  2   3 , Salman Mohagheghi  4 , Andrew Tot Bui  2 , Naomi Wong Hemme  5 , Eric Johnson  2
Affiliations

A Novel Approach to Locating Community Clinics to Promote Health Care Accessibility and Reduce Health Disparities in Baltimore, Maryland

Caitlin DeClercq et al. Inquiry. 2023 Jan-Dec.

Abstract

Baltimore, Maryland's entrenched racial residential segregation renders the city's world-class medical facilities and services inaccessible to many Black residents living in its most divested neighborhoods. Arguing the need for post-pandemic health care facilities to address health inequities as a practice of care-giving, this article describes a project funded by the National Institutes of Health (NIH) to define a novel, transdisciplinary methodology for identifying ideal vacant sites for conversion into community clinics in Baltimore's most vulnerable neighborhoods. Positioning architecture as a social determinant of health, this paper suggests ethical and methodological reorientations toward a compassionate approach to clinic design and placement.

Keywords: Baltimore; community clinics; delivery of health care; health disparities; pandemics; social determinants of health.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Map of the population distribution of residents by race in Baltimore, Maryland. Source: City of Baltimore, Department of Planning, 2020.
Figure 2.
Figure 2.
Abandoned homes in Baltimore number at least 16,000 across the city, with concentrations higher in the neighborhoods of focus in this paper. Source: Carol M. Highsmith, Public domain, via Wikimedia Commons.
Figure 3.
Figure 3.
Life expectancy in Baltimore (data from 2013). Note how Lawrence T. Brown’s “Black butterfly” and “White L” are visible in these patterns. Source. Baltimore City Health Department.
Figure 4.
Figure 4.
Socially vulnerable areas, defined by census tract and identified by our team’s calculation of social vulnerability (on right) within the study area (on left). Image by Andrew Bui, informed by the work of Salman Mohagheghi.
Figure 5.
Figure 5.
Socially vulnerable tract areas from Figure 3 translated into Google Maps. By Andrew Bui.
Figure 6.
Figure 6.
Layered data from public sources (Google, City of Baltimore). By Andrew Bui.
Figure 7.
Figure 7.
Sample map of idea and unideal locations, in tracts 1504 and 1303. Darker blue areas indicate desirable locations; large red circles are undesirable locations. Small dots indicate available sites (abandoned buildings). Image by Andrew Bui.
Figure 8.
Figure 8.
Itinerary for site visit, mapped onto study area. Image by Andrew Bui and Naomi Hemme.
Figure 9.
Figure 9.
Graphic representation of site visit observations. Image by Andrew Bui.
See this image and copyright information in PMC

References

    1. City of Baltimore Department of Planning. Data and Demographics. 2020 Census Data, “Racial Demographics by Neighborhood.” Accessed December 4, 2022. https://planning.baltimorecity.gov/planning-data.
    1. Brown L. Two baltimores: the white l and vs. the black butterfly. Baltimore Sun. 2016. Accessed December 3, 2022. https://www.baltimoresun.com/citypaper/bcpnews-two-baltimores-the-white-....
    1. Foster L.The black butterfly: racial segregation and investment patterns in baltimore. Urban Institute. 2019. Accessed December 3, 2022. https://apps.urban.org/features/baltimore-investment-flows/.
    1. Brown L.The Black Butterfly: The Harmful Politics of Race and Space in America. Johns Hopkins University Press; 2021.
    1. Scott A.Inequality by design: how redlining continues to shape our economy. NPR Marketplace. 2020. Accessed September 24, 2022. https://www.marketplace.org/2020/04/16/inequality-by-design-how-redlinin....

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