Inequality Pharmacies

Fewer Pharmacies In Minority Neighborhoods

One reason for worse health outcomes for racial minorities could be reduced access to pharmacies. However, how big a problem is pharmacy access? A recent Health Affairs paper by Guadamuz et al. (2021) uses 2007-2015 data from the National Council for Prescription Drug Programs (NCPDP) to identify pharmacies, which were then geocoded and linked to the American Community Survey (ACS) to obtain census tract level neighborhood characteristics. These data came from cities with more than 500,000 individuals. The key outcomes of interest were (i) the number of pharmacies in an area and (ii) whether the census tract was a “pharmacy desert”, based on whether the mean distances to the nearest pharmacy exceed a specific threshold.

Using this approach, the authors found that:

In 2015 there were disproportionately more pharmacy deserts in Black or Hispanic/Latino neighborhoods than in White or diverse neighborhoods, including those that are not federally designated Medically Underserved Areas. These disparities were most pronounced in Chicago, Illinois; Los Angeles, California; Baltimore, Maryland; Philadelphia, Pennsylvania; Milwaukee, Wisconsin; Dallas, Texas; Boston, Massachusetts; and Albuquerque, New Mexico. We also found that Black and Hispanic/Latino neighborhoods were more likely to experience pharmacy closures compared with other neighborhoods.

As these data come from 2015, it would be interesting to see if the health impact of a lack of pharmacies has attenuated if there has been an increased use of online pharmacies. On the other hand, in 2021, the health impact may be more significant as an increasing number of individuals are getting their COVID-19 vaccines from pharmacies and a lack of minority access to pharmacies also has the potential to prolong the COVID-19 pandemic.

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