Beyond Access: Social Safety Nets and the Use of Free Health Care Services

We explore how social safety nets shape the utilization of services in a free health care clinic. Sociological research demonstrates that social interactions greatly influence decision making and help-seeking behaviors. However, little is known about the role of community-based organizations (CBOs) in this process and whether the effect of social safety nets varies across different types of services. Using original survey data from 1,044 patients at a free health care clinic, we find clear evidence that one's social safety net, comprising CBOs and health-related discussion network ties, significantly affects the utilization of specialty care. Patients who are embedded in a social safety net are more likely than others to use these types of services. Importantly, this pattern does not hold for a patient's use of primary care services. Our findings emphasize the importance of further examining the role of social safety nets, once access to health care is guaranteed.