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Cynthia R. Ronzio, PhD and Mark F. Guagliardo, PhD. Center for Health Services and Community Research, Children's National Medical Center/George Washington University Medical Center, 111 Michigan Ave, NW, Room 6103, Washington, DC 20010, 202.884.3454, cronzio@cnmc.org
Background: Although there are important individual characteristics that influence utilization of mental health services, it is important to ask whether structural factors of the mental health system explain some of the under-utilization of mental health care specialists among poor and minority populations.
Objective: To investigate local geographic disparities in the location of mental health providers in relation to population demographics.
Methods: Provider-to-population ratios for each census tract in Washington, D.C. first were computed using density calculations and map algebra. Associations between local provider-to-population ratios and neighborhood demographics were examined with Spearman rank correlations.
Results: We found strong and negative correlations between the provider-to-population ratio and neighborhood demographics, which included percent of families headed by a single woman, percent of African Americans, and percent of families receiving assistance. The Spearman's rank correlation between the mean psychiatrist-to-population ratio and percent African American is r= -0.74, p<0.0001. We constructed density maps of the provider-to-population ratios, by type of specialist, to demonstrate graphically the role that residential segregation by socioeconomic status and race/ethnicity plays in spatial access to mental health services.
Conclusions: The disparity in geospatial accessibility of specialists that this study documents may constitute an important barrier for minority and low-income persons seeking mental health care. Moreoever, the effect of distance on access to mental health services is regressive with respect to the social characteristics of patients. Persons with limited economic resources and work flexibility feel the burden of travel time more keenly.
Learning Objectives:
Keywords: Geographic Information Systems, Mental Health Services
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.