Spatial accessibility to primary care and major health conditions in Chicago: a cross-sectional study

Primary care is a cornerstone of population health, yet the relationship between individual-level primary care accessibility and a broad spectrum of major health conditions remains incompletely understood. In Chicago, where marked socioeconomic and spatial health disparities exist, understanding how primary care accessibility relates to disease burden is particularly important. Therefore, we investigated the association between individual-level spatial accessibility to primary care and several major health conditions in Chicago in this study. This cross-sectional analysis included participants of Chicago Multiethnic Prevention and Surveillance Study (COMPASS), a cohort study that enrolled adults in Chicago to investigate population health. Primary care accessibility scores were calculated using enhanced two-step floating catchment area approach, based on participants’ residential locations and primary care practice locations. Modified Poisson regression models were fitted to examine associations between quartiles of primary care accessibility and the prevalence of self-reported health conditions, including obesity, hypertension, type 2 diabetes, asthma, heart attack, anxiety, depression, bipolar disorder and breast cancer, through prevalence ratio (PR). Stratified analyses evaluated whether associations differed by neighborhood socioeconomic status. Our analysis included 6,603 COMPASS participants enrolled between 2013 and 2020. The participants had a median age of 53.9 years (interquartile range, 45.8–60.4 years), 49.5% were female, and 85.4% were non-Hispanic Black. Greater spatial accessibility to primary care was associated with lower prevalence of several major health conditions, particularly hypertension, type 2 diabetes, and depression. These findings underscore the potential population health benefits of improving equitable access to primary care.