Neighborhood Context and Access to Healthcare: Does Residential Instability Matter?

Toshiko Kaneda, Population Reference Bureau
James B. Kirby, U.S. Department of Health and Human Services (DHHS)

Many Americans do not have access to adequate medical care. Previous research on this problem focuses primarily on individual-level determinants of access such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed medical care, however, has not received much attention. We address this gap in the literature by investigating the association between neighborhood residential instability and access to healthcare. Using individual-level data from the 2000 Medical Expenditure Panel Survey and neighborhood-level data from the 2000 decennial census, we find that individuals who live in neighborhoods with high residential turnover have poor healthcare access compared to residents of other neighborhoods. This association persists even when the prevalence of poverty in neighborhoods, the supply of healthcare in counties, and a variety of individual characteristics are held constant. We offer explanations for these findings and suggest directions for future research.