Access to Primary Health Care: Does Neighborhood of Residence Matter?

Neighborhood social and physical contexts have the ability to impact health and health behaviors of residents. One neighborhood characteristic that remains underexamined in the research is access to health care resources. This research examines potential (geographical) access to primary health care in the city of Mississauga, Ontario, Canada. A modification of the two-step floating catchment area method that better suits the study of locally relevant natural neighborhood units is presented. Potential access to health care is measured in each of Mississauga's neighborhoods considering several spatial and aspatial (i.e., social) characteristics of the population and of physicians, including the raw abundance of physicians, languages spoken by physicians and patients, and whether physicians are accepting new patients. Neighborhood-level results are compared to census tracts. The results of this analysis reveal that potential access significantly differs between neighborhoods for all spatial and aspatial dimensions of access. Accessibility is considerably reduced for linguistic minorities and for those who might not have a dedicated family physician as compared to the general population. This research contributes to the existing body of literature on neighborhoods and health by demonstrating the utility of an alternative methodology for developing a more comprehensive understanding of access to health care within natural geographical neighborhoods.