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Racial Disparities In Access To Pharmacy And Its Services In Pennsylvania

      Objectives

      Persistent racial and ethnic disparities in the use of prescription medications often results into inequalities in health outcomes. Existing literature lacks evidence about how low access to pharmacy services may cause differences in the medication use among different race and ethnic groups. The goal of this study is to examine whether access to pharmacies varies across Pennsylvania counties based on their racial or ethnic composition.

      Methods

      In this retrospective study, 10 counties in Pennsylvania, five with highest percentage of white population (White counties) and five with the highest black population (Black counties) were identified using the U.S. census data of 2010 and 2014. Pharmaceutical Assistance contract for the Elderly (PACE) dataset of 2015 was used to identify characteristics of pharmacies and their services for each county. Access to pharmacy and its services was identified using number and type of pharmacy as well as type of services. Chi-square test was used to compare differences in the distribution of pharmacies and types of services provided across the White and Black counties.

      Results

      The five White counties were identified as Elk, Cameron, Jefferson, Warren, and Potter. The five Black counties were Delaware, Forest, Dauphin, Alleghany, and Monroe. The results showed only one pharmacy per square mile in Black counties (4,479 residents per pharmacy) in contrast to 24 pharmacies per square mile in White counties (4,330 residents per pharmacy). There were significantly more independent pharmacies (χ2 = 59.43, p = <0.0001) and delivery services (χ2 = 21.553, p = <0.0001) in the White counties compared to the Black counties. However, Black counties were found to have more chain pharmacies (χ2= 57.97, p = <0.0001) and 7-day services (χ2 = 100.62, p = <0.0001).

      Conclusions

      There is not equal access to pharmacies or pharmacy services between the identified White and Black counties in Pennsylvania.