Study: One-Third of Neighborhoods in Large US Cities Are Pharmacy Deserts

New research suggests that a lack of pharmacies in minority neighborhoods may be contributing to persistent racial and ethnic health disparities, even in the largest cities in the United States.

Investigators at the University of Southern California found that Black and Latino neighborhoods in the 30 most populous cities in the United States had fewer pharmacies than white or diverse neighborhoods between 2007 and 2015. Pharmacies are playing an increasingly important role in the holistic health of patients, including through dispensing medications for chronic illnesses and critical drugs, such as naloxone to reverse opioid overdoses, according to the study.

Despite this important role, neighborhoods in many major cities, such as Los Angeles, Chicago, Houston, and Memphis, lack convenient access to a pharmacy.

“We focused on cities because of racial/ethnic residential segregation and the fact that more than 80% of the Black and Latino population in the US live in cities,” said senior author Dima Mazen Qato, PharmD, MPH, PhD, in a press release. “Our findings suggest that addressing disparities in geographic access to pharmacies—including pharmacy closures—is imperative to improving access to essential medications and other health care services in segregated minority neighborhoods.”

The investigators focused on census tracts and neighborhoods in cities with populations of 500,000 or more. Data from the US Census Bureau’s American Community Survey established neighborhood characteristics including total population, percentage of the population by race and ethnicity, low-income status, and vehicle ownership. Data on pharmacy locations and types of pharmacies came from the National Council for Prescription Drug Programs.

The researchers overlaid census tract maps with pharmacy locations, and then classified neighborhoods in which the average distance to the nearest pharmacy was 1 mile or more as pharmacy deserts. In neighborhoods that were low income and had at least 100 households with no vehicle, the qualifying distance dropped to a half-mile or more in order to account for transportation barriers.

“Traveling a mile to get your prescription medications may be convenient for people that own a car,” Qato said in the press release. “Traveling a mile, or even half a mile, may be difficult for people who live in low-income neighborhoods and don’t drive, particularly older adults who rely on walking or public transportation.”

The prevalence of pharmacy deserts varied widely across cities. For example, in New York and Philadelphia, fewer than 10% of neighborhoods met the definition of pharmacy deserts. However, more than 60% of neighborhoods in Indianapolis, San Antonio, and Charlotte were pharmacy deserts.

“One in 3 neighborhoods throughout these cities were pharmacy deserts, affecting nearly 15 million people,” said first author Jenny S. Guadamuz, PhD, in the press release. “However, limited access to pharmacies disproportionately impacts racial and ethnic minorities—8.3 million Black and Latino residents of these cities live in deserts.”

In all cities, the study found that segregated Black or Latino neighborhoods were more likely to be pharmacy deserts than white or diverse neighborhoods. These disparities were most notable in Los Angeles, Chicago, Albuquerque, Memphis, Boston, Milwaukee, Baltimore, and Philadelphia.

“We observed stark disparities in Los Angeles, where one-third of all Black and Latino neighborhoods were pharmacy deserts, particularly neighborhoods in South Central LA, including Florence, Broadway-Manchester, and Watts,” Guadamuz said.

In Chicago, 1% of white neighborhoods were pharmacy deserts compared to 33% of Black neighborhoods in the South Side neighborhoods of Chatham, West Pullman, and Greater Grand Crossing. The investigators said policy changes may be able to help address these situations, such as targeted grants and tax benefits to encourage pharmacies to locate to pharmacy deserts. Other incentives could motivate pharmacies to offer services such as home delivery to improve access.

REFERENCE

Hopper L. One-third of all neighborhoods in the largest US cities have been ‘pharmacy deserts.’ University of Southern California; May 3, 2021. https://news.usc.edu/185748/pharmacy-deserts-american-cities-health-disparities-usc-research/. Accessed May 6, 2021.