Poverty has long been concentrated in the large cities of the United States while suburban neighborhoods tended to house more affluent populations. But the poor are increasingly looking to the suburbs, and in some cases rural areas, to find jobs and affordable housing as economic forces make cities less affordable—a change that has important implications for access to health care.
Although poverty is increasing in both city and suburban neighborhoods, particularly in Midwestern and Southern metropolitan areas, there appears to be a shift in where the largest concentrations of poverty exist. In 1999, large US cities and their suburbs were home to nearly equal numbers of poor individuals, with 10.38 million living in cities and about 10.25 million living in the suburbs, according to a report released by the Brookings Institution in December (http://www.brookings.edu/metro/pubs/20061205_citysuburban.htm). But by 2005, poor individuals living in suburban areas outnumbered those living in the city by at least 1 million, with 10.95 million in the city and 12.23 million in the suburbs.
Kuehn BM. Poverty Shift May Burden Health System. JAMA. 2007;297(10):1047-1048. doi:10.1001/jama.297.10.1047