The role of community health centers in reducing racial disparities in spatial access to primary care

Introduction: Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers’ (CHCs) role in reducing disparities. Methods: We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility. Results: Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7.84, P = 0.001) were more likely to be near a CHC and those with moderate rates of uninsurance (10%-19% vs <10%, OR = 0.42, P = .045) were less likely. Racial composition was not associated with proximity. Tracts close to a CHC were less likely (OR = 0.11, P < .0001) to be in a low access area. This association did not differ based on racial composition. Discussion: Although CHCs were more likely to be in areas with a greater fraction of racial minorities, location was more strongly influenced by public insurance rates. CHCs reduced the likelihood of being ...