Service deserts and service oases: Utilizing geographic information systems to evaluate service availability for individuals with autism spectrum disorder.
Amy Drahota, Richard Sadler, Christopher Hippensteel and 2 others
PMID 32564619WHAT IT FOUND
Service deserts exist for autism care in Michigan.
Rural areas and low-income urban neighborhoods, particularly Detroit, have significantly fewer providers and longer travel distances than wealthier suburbs. This geographic gap limits access to essential behavioral and educational services.
Key findings
01Almost 60% of rural Michiganders are more than 10 miles from an ASD provider, compared to only 3.34% of urban and 4.79% of suburban residents.
02Low-income urban areas have a severe shortage of providers, with 62% of urban ASD providers located in high-SES areas despite 58% of the urban population living in low-SES areas.
03Detroit was identified as a statistically significant 'cold spot' for ASD service availability, contrasting with nearby wealthier suburbs that were 'hot spots'.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The provider database was built from web searches, potentially missing providers who do not advertise online, especially in rural areas. The study assumes access is contingent on car ownership, which may not reflect families using public transit or school transport. It measures geographic availability, not actual service quality, waitlists, or insurance acceptance. Home-based services are not accurately reflected by provider office locations.
The easy way to misread this
Do not assume that geographic availability equals access to care. This study maps provider locations, not whether those providers accept Medicaid, have open spots, or offer the specific intensity of therapy a patient needs. A provider within 10 miles may still be effectively inaccessible.