Newly arrived refugee's access to primary care physicians in San Antonio, Texas: Geographic Information Systems spatial analysis

Nicole J Wong, The University of Texas School of Public Health


Refugees arriving in the United States are met with a multitude of challenges, especially in accessing health care. San Antonio, Texas, annually resettles about 700 refugees through a single refugee resettlement agency. One of the greatest needs the agency has identified is its need for more partnership with primary care physicians (PCPs). The current number of PCPs utilized by the agency is insufficient to meet the healthcare needs of newly arrived refugees. This study focuses on geographic distance to health care providers as a physical barrier for healthcare access. The research aims include: 1) produce maps displaying the ratio of PCPs to refugees with a geospatial method called 2-step floating catchment (2SFCA) accessibility scores (method allows for calculating the ratio by travel time distances), 2) determine if increasing travel times significantly impact accessibility to PCPs, and 3) describe relationship between demographic factors of refugees and accessibility scores with descriptive GIS maps. Although the general linear model analysis resulted in no significant findings between accessibility scores with increasing travel times, the descriptive maps suggest comparatively lower accessibility to PCPs for refugee populations who do not reside within the medical center area of San Antonio. This includes refugees from Iraq, Burma, and Iran, and those with health referrals for counseling, blood abnormalities, vision, audiology, and women's health. There is also indication of decreased accessibility to family/general practice PCP compared to pediatric PCPs. The refugee resettlement agency in San Antonio should strongly consider placing newly arrived refugees at apartment complexes near the medical center area. Increased attention should also be placed on refugees clusters along Interstate Highway Loop 410 west and east of the medical center. Additionally, there should be consideration to place single adults in apartments near downtown due to the higher density of general practice PCPs and to spread out the spatial need for PCPs among the refugee population. Other suggestions for increasing PCP access among refugees include health literacy education for refugees, demonstrating to refugees how to travel to health appointments, and increasing awareness of healthcare providers on refugee health needs and experiences.

Subject Area

Geographic information science|Public health|Ethnic studies

Recommended Citation

Wong, Nicole J, "Newly arrived refugee's access to primary care physicians in San Antonio, Texas: Geographic Information Systems spatial analysis" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1566381.