Pharmacy access varies greatly across D.C.

June 03, 2019
  • Yesim Sayin Taylor
  • Kathryn Zickuhr
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The D.C. Council spent a significant amount of time discussing health accessespecially access to hospitals, during budget deliberations this past monthWe wondered: how does access to pharmacies—one of the simplest and most basic form of health carevary across the city?  

Pharmacies are an important link between hospitals, doctors, and patients. Pharmacies can expand the reach of preventative services in communities with less access to other providers, improving both individual health outcomes and the public health of communitiesfor example, by advertising the availability of vaccines, or the need to check blood pressure. Variation in access to pharmacies across the city are also connected to broader, ongoing discussions about health equity and economic opportunities in the District, and the building blocks of D.C.’s formal and informal health care infrastructure. Pharmacies are a particularly notable part of the health landscape for children with chronic conditions who need regular access to medications, such as asthma medication 

However, just as many economically and racially segregated neighborhoods have low access to primary care physicians, those same communities may also have fewer options for pharmacy services. Taking into account income and transportation access in addition to pharmacy locations, a 2012 Health Affairs article found that over one million Chicago residents live in “pharmacy deserts.” These pharmacy deserts were more common in segregated black and Hispanic neighborhoods, and this pattern that could contribute to disparities in the use of needed prescription medications. “People living in segregated minority—particularly segregated black—communities needed to travel farther to get to a pharmacy, compared to people in segregated white communities,” the authors wrote, adding that “the differences among community types were particularly pronounced for communities that were also low income. 

A brief examination of pharmacy license data from the D.C. Department of Health from 2016 suggests that D.C.’s residents also face stark disparities in access to pharmacies. That year, the city reported issuing 145 licenses to operating pharmacies.  Pharmacies in the District of Columbia are heavily concentrated in D.C.’s downtown and daytime centers of population, with 36 licensed pharmacies in Ward 2 and 25 in Ward 6. Ward 3 has 21 pharmacies, while Ward 7 has only seven, and Ward 8 has 12. 

Three side-by-side maps of the District of Columbia, illustrating location of pharmacies, number of pharmacies by ward, and number of children deemed eligible for CHIP per pharmacy

Comparing this to the number of children who applied and were eligible for Medicaid and CHIP, a measurement that captures factors around both household income and health, show even stronger contrastsThe data shows that children in low-income households (measured here as those deemed eligible for Medicaid/CHIP), who are more likely to experience poor health and chronic health conditions, have the weakest access to pharmacy services. As the maps above show, Ward 3 has an average of 31 Medicaid/CHIP-eligible children per licensed pharmacy, compared with 2,211 eligible children per pharmacy in Ward 71,594 in Ward 8, and 1,029 in Ward 4.1 

This is not a full picture of health care access across D.C., or even a full picture of access to pharmacies—there may be additional gaps in what level of access to medicine and services residents may have at pharmacies in different locations. But it demonstrates that even this part of the health care ecosystem is weaker in parts of the city with the greatest need, connected to ongoing inequities in health care infrastructure, economic opportunity, and the commercial entities—including pharmacies, but also grocery storesgyms, and restaurantsthat contribute to both individual and public health outcomes. 

 

About the data 

Data on the number of pharmacies in D.C. and by ward are from DC Open Data, Pharmacy Locations. This data includes the location of pharmacies licensed in the District of Columbia as of November 4, 2016. This dataset was created as part of the DC Geographic Information System (DC GIS) for the D.C. Office of the Chief Technology Officer (OCTO) and the D.C. Department of Health. The data’s original source was a database provided by the D.C. Department of Health (Health Regulation and Licensing Administration, Pharmacy Control Division), which identified pharmacy locations. 

Data on the number of children eligible for CHIP/Medicaid per pharmacy by ward as of June 2017 are from the Annie E. Casey Foundation’s KIDS COUNT Data Center. This data set, Children applied and eligible for Medicaid/CHIP by ward in District of Columbia, shows the number of children and youth under age 18 in families who applied and were deemed eligible for Medicaid/CHIP in June of 2017The data’s original source was the D.C. Department of Health Care Finance’s Division of Analytics and Policy Research. 

 

Yesim Sayin Taylor is the Executive Director of the D.C. Policy Center 

Kathryn Zickuhr is the Director of Policy at the D.C. Policy Center  

Authors

Yesim Sayin Taylor

Executive Director
D.C. Policy Center

Yesim Sayin Taylor is the founding Executive Director of the D.C. Policy Center.

With over twenty years of public policy experience in the District of Columbia, Yesim is recognized by policymakers, advocates and the media as a source of reliable, balanced analyses on the District’s economy and demography.  Yesim’s research interests include economic and fiscal policy, urban economic development, housing, and education. She is especially focused on how COVID-19 pandemic is changing regional and interregional economic interdependencies and what this means for urban policy. Her work is frequently covered in the media, including the Washington Post, the Washington Business Journal, the New York Times, the Wall Street Journal, WAMU, and the Washington City Paper, among others.

Before joining the D.C. Policy Center, Yesim worked at the District of Columbia Office of the Chief Financial Officer leading the team that scored the fiscal impact of all legislation the District considered. She frequently testified on high profile legislation and worked closely with the executive and Council staff to ensure that policymakers fully understand the fiscal implications of their proposed legislation. Yesim also has worked in the private sector, and consulted with international organization on a large portfolio of public finance topics.

Yesim holds a Ph.D. in economics from George Mason University in Fairfax, Virginia, and a bachelor’s degree in Political Science and International Relations from Bogazici University, located in Istanbul, Turkey. 

Kathryn Zickuhr

Former Director of Policy
D.C. Policy Center

Kathryn Zickuhr served on the D.C. Policy Center staff as the Director of Policy from its founding until May 2020.

Prior to joining the Center in January 2017, Kathryn was a research analyst at the Pew Research Center’s Internet & Technology Project, where she studied topics such as the changing role of public libraries in American communities and the digital divide. Kathryn holds a Master of Public Policy degree from Georgetown University’s McCourt School of Public Policy and a Bachelor of Arts in history and Russian from the University of Kansas.