Effects of Community Factors on Access to Ambulatory Care for Lower-Income Adults in Large Urban Communities

This study examines the effect of community factors and individual factors on access to ambulatory care for low income adults in 54 metropolitan areas across the United States. Two indicators were used to measure access: (1) having a usual source of care; and (2) having had at least one physician visit in the past year. Several community factor variables were shown to be significant predictors of having at least one physician visit. The influence, however, was different for the two measures of access used and for the insured and the uninsured. The study confirms that the community environment and public policies have significant influence on access to care and that expanding Medicaid and the number of safety net providers would improve access for vulnerable populations.