Some potential points to spur discussion:

  • Generally, higher shares of insured residents, regardless of private, Medicaid, or Medicare policy holders, lead to a higher likelihood of a county potentially having at least some healthcare establishments. A significant exception are optometrists who are less likely to locate in areas with high shares of Medicare recipients, likely due to the limited availability of vision coverage in Medicare plans (routine eye exams and glasses are not covered).
  • Counties appear present structural as well as economic barriers to optometrist establishments in these industries seeking to locate there. For example, the presence of potential patients may not be enough to remain a viable business. Instead these establishments may require an additional location specific feature such as a highly skilled labor force, a high per capita income, or a high share of residents with financial access to health care to sustain a viable business.

For the detailed journal article from which this map derives, see Van Sandt, Anders, Craig Wesley Carpenter, Rebekka Dudensing, and Scott Loveridge. 2021. “Estimating Determinants of Healthcare Establishment Locations with Restricted Federal Administrative Data.” Under review.

This project was supported by the Agricultural and Food Research Initiative Competitive Program of the USDA National Institute of Food and Agriculture (NIFA), award number 2017-67023-26242.


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