Examining equity in accessibility to multi-tier healthcare services across different income households using estimated travel time

Jin, Tanhua; Cheng, Long; Wang, Kailai; Jun, Cao; Huang, Haosheng; Witlox, Frank

doi:10.1016/j.tranpol.2022.03.014

Cited by 59 publications

(27 citation statements)

References 54 publications

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“…For instance, areas with a higher density of transport disadvantages should have access to a variety of means of transportation, including local access initiatives, community transport, and a paratransit system [ 43 ]. Beyond the pre-existing system, private firms, such as Uber, might be encouraged to fill the accessibility gaps that public transit services are unable to fill [ 34 ]; for instance, ridesharing services, such as Uber, can be promoted to fill the temporal and spatial gaps that public transit services cannot fill. For instance, the Pinnellas Suncoast Transit Authority in Florida has initiated a program that partners with Uber to provide free trips to low-income neighborhoods [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…This study developed two GMM algorithms to explore spatial clusters that differed in accessibility by two modes of transportation (i.e., car and public transportation) since accessibility by car and public transportation generally differ from one another [ 34 ]. Thus, this study generated one set of clusters with a focus on accessibility by automobile using Access 1 to 9, and another set of clusters with a focus on accessibility by public transportation using Access 10 to 18 (see Table 2 ).…”

Section: Methodsmentioning

confidence: 99%

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Spatial and Socioeconomic Inequalities in Accessibility to Healthcare Services in South Korea

Lee

2022

Healthcare

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This study explored questions of (1) whether certain areas of South Korea experienced inequal accessibility to public health centers, private hospitals/clinics, and general hospitals by car and public transportation using gaussian mixture models (GMM) and (2) whether socially disadvantaged socioeconomic groups faced disproportionate burdens on accessibility to the multi-tier healthcare services employing ordinary least square regression models (OLS). This study used nationwide accessibility indicators in South Korea measured by Korea Transport Institute in 2019. The main findings were as follows: First, the results of the GMM indicate that the degree of accessibility to healthcare services was significantly lower in rural, mountainous, and seaside locations compared to metropolitan areas. Second, there was more considerable inequality in public transportation accessibility than car accessibility. Third, the findings of the OLS reveal a significant relationship between accessibility indicators and socioeconomic variables, such as age, gender, disability, and residential location, which indicates socioeconomic inequality in accessibility in South Korea. This study contributes to shedding light on understanding the spatial and socioeconomic inequality in accessibility across the nation and offering policy implications.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Spatial and Socioeconomic Inequalities in Accessibility to Healthcare Services in South Korea

Lee

2022

Healthcare

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“…Mao and Nekorchuk [76] develop a modified 2SFCA framework incorporating multi-mode transportation. For the distance decay of weight in the catchment area, some studies have introduced distance decay functions, including Gaussian function [26,77], kernel density function [78], and power function [50], addressing the problem of uniform access within the catchment by applying weights to different travel time zones to account for distance decay [79].…”

Section: Calculating the Spatial Accessibility Of Elderly Care Facili...mentioning

confidence: 99%

“…In the aspect of spatial distribution research, nearest neighbor hierarchical clustering [81], Ripley's K function [82], Gini coefficient [16], Shannon entropy [45], and spatial autocorrelation [26,83,84] are often used to explain the aggregation status of facilities in geospatial space. Spatial autocorrelation could observe the correlation between variables close to each other on a spatial scale, more conveniently identifying the areas with a significant imbalance between supply and demand.…”

Section: Analysis On Spatial Distribution Equilibriummentioning

confidence: 99%

“…Access refers to the possibility of reaching a place, goods, services, etc., also known as access opportunity and convenience [25]. Accessibility assessment is one of the main methods of research on the rationality of the spatial distribution [26][27][28], which is widely used in the layout evaluation of public service facilities, such as education, medical treatment, elderly care facilities, parks, and green spaces [29,30]. Countries that also face serious aging problems, such as Japan [31,32], South Korea [33], Finland [34], and the United States [35,36], have also attracted extensive attention from scholars to study the accessibility of public service facilities.…”

Section: Introduction 1backgroundmentioning

confidence: 99%

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Study on Spatial Distribution Equilibrium of Elderly Care Facilities in Downtown Shanghai

Huang

Gong

White

2022

IJERPH

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With the growing challenge of aging populations around the world, the study of the care services for older adults is an essential initiative to accommodate the particular needs of the disadvantaged communities and promote social equity. Based on open-source data and the geographic information system (GIS), this paper quantifies and visualizes the imbalance in the spatial distribution of elderly care facilities in 14,578 neighborhoods in downtown (seven districts) Shanghai, China. Eight types of elderly care facilities were obtained from Shanghai elderly care service platform, divided into two categories according to their service scale. With the introduction of the improved Gaussian 2-step floating catchment area method, the accessibility of two category facilities was calculated. Through the global autocorrelation analysis, it is found that the accessibility of elderly care facilities has the characteristics of spatial agglomeration. Local autocorrelation analysis indicates the cold and hot spots in the accessibility agglomeration state of the two types of facilities, by which we summarized the characteristics of their spatial heterogeneity. It is found that for Category−Ⅰ, there is a large range of hot spots in Huangpu District. For Category−Ⅱ, the hot-spot and cold-spot areas show staggered distribution, and the two categories of hot spot distribution show a negative correlation. We conclude that the two categories are not evenly distributed in the urban area, which will lead to the low efficiency of resource allocation of elderly care facilities and have a negative impact on social fairness. This research offers a systematic method to study urban access to care services for older adults as well as a new perspective on improving social fairness.

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Advances and pitfalls in measuring transportation equity

Karner,

Pereira,

Farber

2024

Transportation

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Transportation systems play a pivotal role in facilitating access to out-of-home activities, enabling participation in various aspects of social life. But because of budgetary and physical limitations, they cannot provide equal access everywhere; inevitably, some locations will be better served than others. This realization gives rise to two fundamental concerns in transportation equity research and practice: 1) accessibility inequality and 2) accessibility poverty. Accessibility inequalities may rise to the level of injustice when some socioeconomic groups systematically have lower access to opportunities than others. Accessibility poverty occurs when people are unable to meet their daily needs and live a dignified, fulfilling life because of a lack of access to essential services and opportunities. In this paper, we review two of the most widely used approaches for evaluating transport justice concerns related to accessibility inequality and accessibility poverty: Gini coefficients/Lorenz curves and needs-gap/transit desert approaches, respectively. We discuss how their theoretical underpinnings are inconsistent with egalitarian and sufficientarian concerns in transport justice and show how the underlying assumptions of these methods and their applications found in the transportation equity literature embody many previously unacknowledged limitations that severely limit their utility. We substantiate these concerns by analysing the equity impacts of Covid-19-related service cuts undertaken in Washington, D.C. during 2020. The paper also discusses how alternative methods for measuring transportation equity both better comport with the known impacts of such changes and are consistent with underlying moral concerns.

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Examining equity in accessibility to multi-tier healthcare services across different income households using estimated travel time

Cited by 59 publications

References 54 publications

Spatial and Socioeconomic Inequalities in Accessibility to Healthcare Services in South Korea

Spatial and Socioeconomic Inequalities in Accessibility to Healthcare Services in South Korea

Study on Spatial Distribution Equilibrium of Elderly Care Facilities in Downtown Shanghai

Advances and pitfalls in measuring transportation equity

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