Influence of Urban Multi-Criteria Deprivation and Spatial Accessibility to Healthcare on Self-Reported Health

Abstract

Self-reported health is considered a health outcome related to neighborhood characteristics. This study analyzes the influence of urban multi-criteria deprivation and spatial accessibility to healthcare on individual self-reported health from a case study carried out in the city of Quito, Ecuador. A multi-criteria deprivation index and two alternative scenarios of this index were generated. A gravity-based measure of spatial accessibility to healthcare was also calculated. The neighborhood effects of deprivation measures and spatial accessibility to healthcare on individual self-reported health were evaluated by applying multilevel models. Significant neighborhood effects were found in two of the three applied multilevel models. This study contributes evidence of neighborhood effects on health outcomes, and can support urban planners and policy-makers in the reduction of urban health-related inequalities.

Comparing Classic and Interval Analytical Hierarchy Process Methodologies for Measuring Area-Level Deprivation to Analyze Health Inequalities

“…The self-reported health reflects an individual’s integrated perception of health [ 41 ] that is not necessarily associated with objective measures of individual health but nevertheless is associated with more detailed measures of health status such as reported physical and mental health [ 42 ], and also to contextual objective measures of deprivation [ 15 , 39 ]. This means that self-reported health is an enduring concept that remains stable over time at the individual level but changes between groups of individuals living in different neighborhoods and that this change can respond to neighborhood-level characteristics such as deprivation.…”

“…To compare and validate both the MDIQ and the I-MDIQ, the influence of these indices on self-reported health was evaluated. Deprivation influences health outcomes [ 3 , 4 , 34 ] including self-reported health [ 15 , 35 , 36 ]. Thus, regression models can be used to model the relationship between deprivation and self-reported health.…”

“…Additionally, these methods are useful in decision making and planning and can be incorporated in geographic information system (GIS) environments to support spatial multi-criteria analyses of deprivation areas [ 1 , 13 ]. For instance, the order weighted average (OWA) is an MCDA method that has been used to validate deprivation indices that use qualitative information [ 13 ], as well as to create alternative scenarios of a deprivation index [ 1 , 15 ]. The OWA method uses a fuzzy logic that is used to rank the indicators based on their values.…”

“…The interval AHP calculates the weightings through interval pairwise comparison matrices, which means applying a more flexible and accurate AHP. The deprivation index chosen for the study is the multi-criteria deprivation index for the city of Quito [ 15 , 16 ]. This index was constructed using AHP to weight its indicators and has been proven to explain the individual-level variations in health outcomes, to some degree.…”

Housing Indicators for Sustainable Cities in Middle-Income Countries through the Residential Urban Environment Recognized Using Single-Family Housing Rating Systems

“…One of the principal hypotheses that motivated this study was that it is necessary to view housing as an essential part in the development of communities [89]. In order to achieve a residential sector that contributes to increasing the livability of cities and to fit this hypothesis in the MICs, one of the main steps is that the process of urban planning and decision-making needs to establish a cross-relation between the availability of their amenities [90] and their public transport [34,91]. All the SHRSs understand the above, given that all consider the proximity of urban amenities and public transport to the house (Table 7).…”