Neighborhood Health Indicators in Greater Cleveland: The Use of Medicaid Claims to Measure Children's Access to Primary Care

As part of the NNIP cross-site initiative on Neighborhoods and Health, Cleveland's Center on Urban Poverty and Social Change (Case Western Reserve University) developed neighborhood indicators of child access to primary care using eligibility, claims, and encounter data from Ohio's Medicaid data system. Staff members sought to clarify relationships between neighborhood conditions and children's access to primary care. They found that the use of emergency services for non-emergency conditions was positively correlated with poverty rates, minority concentrations, low-birth-weight rates, and child maltreatment. The likelihood of children having recommended preventive care visits, however, did not drop consistently with rates of neighborhood poverty or other health problems, suggesting that efforts to provide preventive services to poor residents may be achieving some success. This analysis is now being reviewed by Cuyahoga County's Early Childhood Initiative (ECI), which plans future work with the researchers using these and other data to build a system that will allow it to better target program resources and monitor performance.