Figure 2. Areas of Zero Access Relative to A) Unemployment, B) Poverty, C-E) Distribution of Race/Ethnicity EVALUATE the distribution of agencies providing.

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Figure 2. Areas of Zero Access Relative to A) Unemployment, B) Poverty, C-E) Distribution of Race/Ethnicity EVALUATE the distribution of agencies providing income-related social services relative to populations in need within the Boston area IDENTIFY disparities in access among populations with different socioeconomic status or racial/ethnic distributions GUIDE future planning of income security agency locations with evidence based on need indicators and existing geographic access The Online Advocate: Social service agency database Agencies contacted to update and confirm location and services provided Income Security Agency Density: Income-related Social Service Agencies defined as those providing direct income support and/or job training Created agency density surface using point density estimation of geo-coded agency locations Adjusted for population living below the federal poverty line (FPL) in each Census Block Group (BG) Data source: The Online Advocate Need indicators: % of population living below FPL % of population unemployed Data sources: 2000 Census, MassGIS, Boston Atlas Geographical Information System (GIS) Analysis: Applied point density estimation to calculate average geographic access to agencies per BG Compared geographic access among BGs defined by need indicators, neighborhood boundaries, or racial/ethnic demographics : PURPOSE METHODS RESULTS Disparities in Access to Income-Related Social Service Agencies Scott R. Bauer ScM 1, Michael Monuteaux ScD 2, Eric Fleegler MD MPH 3 1 Department of Epidemiology, Harvard School of Public Health; Divisions of Clinical Research 2 and Emergency Medicine 3 at Children’s Hospital Boston; Department of Pediatrics, Harvard Medical School Supported by grants from The Office of Child Advocacy at Children’s Hospital Boston Figure 1. Income-related Agency Density Income-related Social Service Agencies are unevenly distributed in the Boston area Many Census Block Groups (BGs) with a large population living below the Federal Poverty Line (FPL) have the little or no geographic access to income-related social services Among populations living below FPL, geographic access was relatively similar across BGs with different racial/ethnic composition Some neighborhoods have especially limited access to resources despite a large population in need CONCLUSIONS * Poverty-Adjusted Agency Density = # Income-related Social Service Agencies per square mile per 100 population below Federal Poverty Level **FPL= Federal Poverty Level (Annual income for a family of 4 under $13,359 in 2000 or $21,954 in 2009) >2 Agencies /sqmi per 100 population below FPL 0-2 Agencies /sqmi per 100 population below FPL 0 Agencies/sqmi/ per 100 population below FPL Total Number of Agencies Population (% Total)148,409 (26.4)223,735 (39.8)189,610 (33.8) Population Below FPL (% Total)24,866 (16.8)51,212 (22.9)31,810 (16.8) Number of Census Block Groups Population Characteristics Number Unemployed (% Total)6,994 (4.7)8,474 (3.8)5,335 (2.8 ) Number of Poor Blacks (%)8,413 (27.4)13,992 (45.6)8,310 (27.1) Number of Poor Hispanics (%)5,110 (20.0)14,090 (55.2)6,315 (24.8) Number of Poor Whites (%)8,432 (21.0)18,720 (46.6)13,018 (32.4 ) Table 1. Income-related Social Service Agency Maldistribution and Associated Population Characteristics at Census Block Group Level