Spatial accessibility and travel to pharmacy in Detroit and its suburbs

Abstract

Abstract Community pharmacies are a critical part of the health care provision system. Yet less is understood about the spatial accessibility to pharmacies and how people travel to reach these services. This study compared spatial accessibility and actual travel to different types of pharmacies in sampled neighborhoods across the Detroit Region, including Urban Detroit neighborhoods with a concentration of low-income African Americans and predominantly high-income white suburbs. The results showed that, overall, low-income African American urban communities face a greater burden in reaching pharmacy services needed. Compared to suburban residents, Urban Detroit residents had higher access to independent pharmacies, but much lower access to national chains, which most residents relied on. In fact, Urban Detroit residents bypassed nearby local independent pharmacies and traveled long distances to use farther locations, primarily national chains. They also tended to shop around more for services. To our knowledge, this is the first study that has compared spatial access and actual travel to different types of pharmacies. It demonstrates that methodologically, it is important to distinguish spatial accessibility among different pharmacy types. In an urban context, supposedly good spatial access considering all pharmacies together may mask excessive burden in reaching the pharmacy services of choice in low-income minority communities, as in the case of Urban Detroit.