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Access to Health Care for Older Persons in the United States

Personal, Structural, and Neighborhood Characteristics

National Center for Health Statistics, Centers for Disease Control and Prevention

Joan F. van Nostrand, DPA

Federal Office of Rural Health Policy, Health Resources and Services Administration

Donna Ronsaville, PhD

Research conducted while employed by the KEVRIC Company, Inc.; Currently with the National Institute of Mental Health

Objective:To determine the contributions of personal, structural, and neighborhood characteristics to differential access to health care for older persons in the United States. Methods:This study used the 1994 National Health InterviewSurvey, ages 65 and older (n= 12,341), 1990 census block group data, and data on health professional shortage areas. Logistic regression was used to model the probability of problems accessing care. Results:The likelihood of access problems increased sharply with decreasing gradients of family income and for those lacking private health care insurance. Rural areas and poor areas were at a disadvantage in accessing care, whereas residents of neighborhoods that were homogeneous in ancestral heritage appeared better able to access care. Discussion:Considering the high association between neighborhood and personal characteristics, it is notable that any neighborhood effects remained after combining them with personal effects.

Journal of Aging and Health, Vol. 13, No. 3, 329-354 (2001)
DOI: 10.1177/089826430101300302


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