The Impact of Community-Level Social and Economic Factors on Healthcare Access Among Individuals With Mental Illness

Aims: We examined how community-level socioeconomic deprivation and residential stability impact healthcare access among a sample of individuals with mental illness.

Methods: We linked five years of the Medical Expenditure Panel Survey (MEPS; 2013–2017) with community-level data, drawing a sample of adults with mental illness in the United Sates (N = 5444). Descriptive statistics and bivariate and multivariable logistic regression models are presented.

Results: Socioeconomic deprivation was negatively associated with access to a usual source of care and positively associated with delaying or forgoing prescription medication. Residential stability was positively associated with having a usual source of care and negatively associated with forgoing or delaying needed care and prescription medication. Residential stability remained negatively associated with delayed or forgone healthcare in adjusted models.

Conclusion: Community-level factors are important determinants of healthcare access above and beyond individual-level predictors. Efforts to improve healthcare access among individuals with mental illness may be optimized by also targeting broader social and economic contexts.