Change in geographic access to community health centers after Health Center Program expansion

Objective

To examine geographic access to community health centers ( accessibility) before and after Health Center Program expansion in three Southern states.

Data Sources

Community health center data were from the Health Resources and Services Administration (1967‐2016). Population estimates and sociodemographic characteristics were from the American Community Survey (2006‐2015).

Study Design

We used the two‐step floating catchment area method to calculate accessibility for census tracts in 2008 and 2016. We mapped census tract‐level variation and used spatial regression to assess to what extent indicators of potential need were associated with change in accessibility from 2008 to 2016.

Principal Findings

Community health center accessibility increased by 192 percent overall, and the proportion of tracts with no accessibility decreased by 65 percent. Indicators of potential need were not associated with greater gains in accessibility from 2008 to 2016, but census tracts with less accessibility at baseline saw larger accessibility increases.

Conclusions

Community health center accessibility substantially increased from 2008 to 2016, but increases did not differentially impact groups with greater potential need. This approach for measuring accessibility offers significant improvement in granularity over traditional accessibility measures.