Income, health, and racial gaps between 340B hospitals, child sites, and nearby neighborhoods.

Objectives: To estimate neighborhood differences between 340B child sites, parent hospital covered entities (CEs), and other neighborhoods near CEs.

Methods: We created a unique dataset that contains CE and child site characteristics, and Zip Code Tabulation Area (ZCTA) socioeconomic and health data in 2022 for over 12 000 out-of-ZCTA code 340B hospital child sites. We computed differences across key measures, including median income, uninsured and unemployment rates, age, and health metrics between each pair and between the child site's ZCTA and all other ZCTAs within a 10-mile radius of the CE.

Results: The median child-site ZCTA income is 28% higher than CE ZCTA income and approximately 11% higher than CE neighborhood ZCTA income. Uninsured rates (11% lower than CE ZCTA and 10% lower than CE neighborhood ZCTA) and unemployment rates (17% and 15% for CE ZCTA and CE neighborhood ZCTA, respectively) are lower in child-site areas and where the share of White residents is higher (11% and 9%, respectively). Average health status is better in child-site ZCTAs despite a higher median age.

Conclusion: Our analysis suggests that 340B entities place child sites in neighborhoods that are wealthier, healthier, better insured, and less diverse than the neighborhoods of both the CE and other neighborhoods within a 10-mile radius of the CE.