Research Alert: August 17, 2023
Availability of Dialysis Facilities and Primary Care Safety Net Providers in Minoritized Racial/Ethnic Group Areas
These briefs document disparities in geographic access to health services for ZIP code tabulation areas (ZCTAs) containing a high proportion of minoritized racial/ethnic group residents. The term "minoritized" refers to groups that have historically been marginalized by society and government institutions. ZCTAs were classified as being a top minoritized place if the proportion of persons in the ZCTA who identified as a specific minoritized racial/ethnic group met or exceeded the 95th percentile for the proportion of those residents in all rural or all urban ZCTAs, respectively. Top minoritized racial/ethnic group ZCTAs are not necessarily "majority minority" places.
- Within rural ZCTAs, median distance to the nearest dialysis facility ranged from 10.5 miles for top non-Hispanic Black ZCTAs to 18.9 miles for top American Indian/Alaska Native ZCTAs. Rural ZCTAs for top non-Hispanic White residents were a median of 16.6 miles from the nearest dialysis facility.
- Within urban ZCTAs, median distance to the nearest dialysis facility was 1.4 miles for non-Hispanic Asian ZCTAs and 8.9 miles for the top American Indian/Alaska Native ZCTAs. However, among urban ZCTAs, non-Hispanic White ZCTAs had the greatest median distance of 10.1 miles.
- Across all ZCTAs, rural locations had a median distance of 14.3 miles to care versus 4.3 miles for urban ZCTAs.
- The more remote the ZCTA, the greater the median distance to care. Distance increases from 16.0 miles in Level 1 Frontier and Remote (FAR) Area Designations to 32.3 miles in Level 4 FAR areas versus 12.2 miles for "all other" rural ZCTAs.
- Rural ZCTAs were located a greater median distance from a Rural Health Clinic (RHC) or a Federally Qualified Health Center (FQHC) than were urban ZCTAs (7.4 versus 4.4 miles).
- The majority of rural ZCTAs (84.3%) were within 15 miles of either an RHC or FQHC.
- Rural ZCTAs were a median of 12.3 miles from the nearest FQHC and 11.0 miles from the nearest RHC.
- The analysis found longer median distances to an RHC or FQHC than did previous research based on Medicare claims from 2009 (11.0 miles to an RHC versus 7.0 miles; 12.3 miles to an FQHC versus 8.7 miles).
Janice C. Probst, PhD
Rural and Minority Health Research Center