Poor People, Poor Places and Access to Health Care in the United States

Research suggests that community-level poverty is associated with access to health care net of individual-level characteristics, but no research investigates whether this association differs by individual-level income. Using data from the Medical Expenditure Panel Surveys, the U.S. Census Bureau and the Health Resource and Services Administration, I find that the negative relationship between the prevalence of poverty in communities and access to health care is much stronger for middle- and high-income individuals than for those in lower-income groups. I suggest that individuals may benefit from living among those in similar economic circumstances because they face similar obstacles to obtaining medical are. For poor individuals, the collective knowledge and experience embedded in poor communities may compensate for the otherwise negative influence of community-level poverty.