Table 2.
Methodology and Results
| Country | National | Local | Country Population Census | Pharmacy data collection source | Pharmacy Census Validation | Pharmacy density per 10,000 population | Distance to pharmacies in relation to pop | Urban/Rural | Ethnicity | Socio-economic status |
|---|---|---|---|---|---|---|---|---|---|---|
| National level data: upper-middle-income economies | ||||||||||
| Brazil | X | X | Saude Legis—database containing legislation and Brazilian Ministry of Health | – | Medium/large municipality: 1.07, Small municipality: 2.15 | – | – | – | Wealthy areas have a higher coverage | |
| South Africa | X | X | Department of Health, SAPC- South African Pharmacy Council | – | 0.61 | – | Urban (least rural) province: 0.99, Most Rural province: 0.27 | – |
Most deprived districts: 0.11/10,000, In province: 0.34/10,000 |
|
| National level data: high-income economies | ||||||||||
| England | X | X | Fuse Geo-Health Care Access Database | – | – | 89.2%—within 20 min walk | – | – | – | |
| England | X | X | Geo-Healthcare Access Database | – | – |
75%—within 10 min walking distance of one another 19%—in a cluster of two 56%—in a cluster of three |
Urban: 19%, 19%, 62% Town: 94%, 5%, 1% Rural: 94%, 4%, 2%—no cluster, cluster of two and three respectively |
– | – | |
| New Zealand | X | X | Till 2005—New Zealand Gazette, the official government journal. 2005–2010: MedSafe, a division of Ministry of Health | – | 2.2 |
In 2010: 86.5%—within 5 km In 2010: 99.8% within 25 km |
Pharmacies centralize in areas of high population | – | Most deprived areas (according to NZDep) are more likely to live close to a pharmacy | |
| United States | X | X | National Council for Prescription Drug Program, 2007–15 | Internal validation by NCPDP | 2.11 | – | – | – | Highest quintiles had threefold more pharmacies than those in lowest quintile | |
| Regional level data: lower-middle-income economies | ||||||||||
| Ujjain district, Madhya Pradesh, India | X | X | Survey by identifying private pharmacies in the community, list from pharmacy association | X | 2.8 | 78% within 50 m from a health care provider, 17% within 50–100 m from a health care provider | Urban: 5.83/10,000. Rural: 0.84 per 10,000 | – | – | |
| Regional level data: high-income economies | ||||||||||
| Baton Rouge, Louisiana, United States | X | X | Not explained | – | 2.5 | 86%—within 10 min, 96%—within 15 min, Average travel time: 8.11 min | – | African–American have better accessibility to pharmacy (7.64 min) than white (8.59 min) | Elderly have easy access to pharmacies compared to general population | |
| Chicago, United States | X | X | Illinois Department of Financial and Professional Regulation for the period 2000–12 | – | 0.64/census tract | – | – | Pharmacy deseeds—clustered on the south and west side in segregated black and Hispanic community | – | |
| Illinois, United States | X | X | Illinois Department of Professional Regulation | – |
Urban: 1.27 Rural: 0.38 |
Average distance: 2.73 km, For elderly: 3.05 km. Entire population: within 32 km, 0.1% rural – travel more |
– | – | – | |
| Liguria, Italy | X | X | Italian Ministry of Health’s open dataset | – | 3.8 |
Mean distance to nearest pharmacy: 6.8 km, 81.7% municipality-had one pharmacy |
Provincial level: 3.6/10,000 Municipal level: 11.07/10,000 |
– | – | |
| Lisbon, Portugal | X | X | National Health System database | – | 13.35 |
88%—live within 800 m Elderly: 89.1% within 800 m Pedestrian distance: 61.2% within 10 min walk, 76.9% within 15 min walk |
Poorly accessible areas seen not only in rural areas but also in norther urbanization corridor | – | – | |
| Minnesota, North and South Dakota, United States | X | X |
State Boards of Pharmacy, Surveys conducted with developed survey instrument |
X | – |
Average distance: Minnesota: 18 km, South Dakota: 29.3 km, North Dakota: 32 km |
Population > 32 km from a pharmacy: Minnesota—0.4%, South Dakota—7.3%, North Dakota—4.3% |
– | – | |
| New York, United States | X | X | New York State registries, survey of selected pharmacy | X |
High poverty regions: 5.1 Low poverty regions: 3.5 |
– | – | – |
For each 10%—point increase in the number of households in poverty, odds of one or more prescription medications unavailability on the pharmacy shelves increases by 24% |
|
| Nova Scotia, Canada | X | X | Nova Scotia college of Pharmacists | – | 12.24 | 42% within 800 m, 62.6% within 2 km and 78.8% within 5 km |
Urban: 61.3%within 800 m, 90% within 2 km and 99.2% within 5 km. Rural:28% within 2 km and 53.3% live within 5 km |
– | – | |
| Ontario, Canada | X | X | Ontario College of Pharmacists | X | 7.96 (From Nova Scotia article) | 63.6%—within 800 m, 84.6% within 2 km and 90.7% within 5 km |
Urban: 73.3%, 96.2% and 99.4% within 800 m, 2 km and 5 km respectively Rural: 8.5%, 18.1%, 40.9% within 800 m, 2 km and 5 km |
– | – | |
| Pennsylvania, United States | X | X | Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE) and PACE Needs Enhancement Tier | X | – | 33%—live more than 1.6 km | Pharmacy deserts – in rural |
Pharmacy deserts have significantly more females, married and white elderly and fewer blacks and Hispanics compared to pharmacy non-deserts |
Median annual household income higher for those living in pharmacy deserts | |
|
Scottish Highland, Scotland |
X | CACL consumer database ‘Ocean’ | Questionnaires sent to a random sample obtained from database ‘Ocean’. Pharmacy locations were identified using respondent’s postcode | – | – |
Median distance travelled – 2.4 km 84.3%—convenient |
Significant association between rurality and convenience – those in most rural areas more likely not convenient | – | Convenience, also associated with good health, younger age and those living with a partner | |
|
Shelby County, Memphis, Tennessee, United States |
X | X | Cross-sectional survey of community pharmacies | X | 1.49 ± 1.04 | – | – | Areas with more pharmacies per 10,000 residents had a higher % of white residents |
High income regions: ≥ 1.88 Low income regions: < 0.72 |
|
| South side Chicago, United States | X | South Side Health and Vitality Statistics | Illinois Department of Financial and Professional Regulation, interviews with pharmacies | – | 1.8 per mi2 | Median distance: 1.93 km, 31% fill prescription from nearest pharmacy | – | – | – | |