Access to Health Services Across Rural and Urban Minoritized Racial/Ethnic Group Areas


This brief summarizes selected results from a series of reports documenting disparities in geographic access to health services for rural and urban places that have a relatively high proportion of residents from minoritized racial and ethnic groups (MRG). "Areas" were examined at the ZIP Code Tabulation Area level (ZCTA).

Key Findings:

Rural places measured at the ZCTA level were generally more likely to exceed distance cutoffs across multiple types of service. Three consistent disparities become evident across summary analyses.

  • Urban ZCTAs in the top 5% for non-Hispanic Black, Hispanic, and non-Hispanic Asian population representation were often closer to needed facilities than were ZCTAs at the top for non-Hispanic white residents. However, only a small proportion of all urban ZCTAs, even those with relatively concentrated minoritized populations, exceed the distance cutoff used in the analyses.
  • Rural ZCTAs in the top 5% for American Indian/Alaska Native (AI/AN) population representation were more likely to exceed 15-mile and 30-mile distance thresholds for various services than any other concentrated ZCTA type. With the exception of the "more than one MRG" category, ZCTAs at the top of the distribution for the proportion of residents identifying as AI/AN had the highest rates of lack of service of any racial/ethnic group in 8 of the 11 types of service examined. It is possible that Indian Health Service facilities or other institutions not fully captured in the data sets remedy this gap but more analysis is needed.
  • Service gaps for rural ZCTAs in the top 5% for Hispanic residents closely parallel those for AI/AN ZCTAs. This distance gap may not be recognized by scholars carrying out analyses that do not explicitly examine rural populations and places. Renewed attention to the rural Hispanic population is required.
Rural and Minority Health Research Center
Janice Probst, Peiyin Hung, Gabriel Benavidez, Elizabeth Crouch, Jan Eberth