# Income, health, and racial gaps between 340B hospitals, child sites, and nearby neighborhoods

## TL;DR

This study finds that 340B hospitals place child sites in wealthier, healthier, and less diverse neighborhoods compared to their parent hospitals and surrounding areas.

## Contribution

The paper introduces a novel dataset and analysis of socioeconomic and health disparities between 340B hospitals, child sites, and nearby neighborhoods.

## Key findings

- Child-site neighborhoods have 28% higher median income than parent hospital neighborhoods.
- Child-site areas show lower uninsured and unemployment rates and better health outcomes.
- Child-site ZCTAs are less racially diverse compared to CE and surrounding neighborhoods.

## Abstract

To estimate neighborhood differences between 340B child sites, parent hospital covered entities (CEs), and other neighborhoods near CEs.

We created a unique dataset that contains CE and child site characteristics, and Zip Code Tabulation Area (ZCTA) socioeconomic and health data in 2022 for over 12 000 out-of-ZCTA code 340B hospital child sites. We computed differences across key measures, including median income, uninsured and unemployment rates, age, and health metrics between each pair and between the child site's ZCTA and all other ZCTAs within a 10-mile radius of the CE.

The median child-site ZCTA income is 28% higher than CE ZCTA income and approximately 11% higher than CE neighborhood ZCTA income. Uninsured rates (11% lower than CE ZCTA and 10% lower than CE neighborhood ZCTA) and unemployment rates (17% and 15% for CE ZCTA and CE neighborhood ZCTA, respectively) are lower in child-site areas and where the share of White residents is higher (11% and 9%, respectively). Average health status is better in child-site ZCTAs despite a higher median age.

Our analysis suggests that 340B entities place child sites in neighborhoods that are wealthier, healthier, better insured, and less diverse than the neighborhoods of both the CE and other neighborhoods within a 10-mile radius of the CE.