Hospitals Alike, Hospitals Different: A study of spatial inequality around Boston’s Acute Care Hospitals

• In Event: 41026 - Social Determinants of Health

Abstract

Health disparities are sustained through segregation, and access to healthcare has been one of the most prominent areas of research in spatial urban disparity studies. Geographic location plays a significant role in how one receives healthcare services, especially for vulnerable populations that reside in areas where healthcare access and quality are diminished. In this study, we examine how spatial inequalities in Boston manifest around its seven acute care hospitals. Using American Community Survey data and the CDC’s PLACES dataset, we compare census tract characteristics—including poverty rates, racial composition, and physical health indicators—across hospital catchment areas. Welch’s ANOVA and Games–Howell tests reveal statistically significant differences among neighborhoods; notably in hospitals serving predominantly people of color and higher poverty areas. Global and bivariate Moran’s I analyses further show moderate-to-strong spatial clustering, with high-poverty and high–people-of-color tracts tending to neighbor similar areas. Ultimately, these findings underscore the urgent need for targeted policy reforms and community-driven interventions to dismantle structural inequities, ensuring that all communities gain equitable access to quality healthcare. These findings show the urgent need for targeted policy reforms and community-driven interventions both on the hospital and policy side.

Author

• Eralp Kaan Karduz, University of Massachusetts-Boston