Disparities in health outcomes for low-income populations as documented by rates of preventable hospital admission remains large in the United States, even with the moderate expansion of Medicaid and efforts at the state and local levels to improve primary care services that began in the mid-1980s. These differences in outcome for rich and poor are not an isolated phenomenon of a few old and decaying Northeast urban centers but are documented in a broad range of urban areas. Much smaller differences are found in urban areas in Ontario, where universal coverage may help to reduce barriers to care.
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