Unequable spatial accessibility to hospitals in developing megacities: New evidence from Beijing

Abstract

The increasing inequality in spatial accessibility to hospitals in developing countries has been attracting attention from researchers and politicians. The situation seems to be worse in growing megacities where more than 10 million people live and rapid urban sprawl has caused serious problems with the supply of health and public transport services. The recent global COVID-19 pandemic calls for particular attention to be afforded to the matter of equal access to basic medical facilities and services for people across different neighborhoods. Although some studies have already been undertaken into the subject of health-focused inequality in the cities of developing countries, the spatial inequity in hospital accessibility has rarely been discussed to date. In this paper, I aim to provide new evidence by considering Beijing as a case study. With the results of my analysis, I show that low-income neighborhoods have experienced lower levels of accessibility not only to high-tier hospitals (secondary and tertiary hospitals) but also to primary healthcare services (primary hospital and neighborhood clinics). The rate at which high-income neighborhoods access secondary and tertiary hospitals is approximately 4 times and 1.5 times as high as that of low-income neighborhoods. Low-income face nearly twice the travel time of those from high-income neighborhoods to reach the nearest primary hospital or neighborhood clinics. Suburban neighborhoods have less access to medical services than neighborhoods that are located in the central urban areas. It seems that the rapid urban sprawl has been worsening spatial inequality in the context of access to medical services in the growing megacity of Beijing. Equal access to healthcare services should be prioritized in future policy discussions, especially in relation to the urban growth management of megacities in developing countries in order to ensure that fair and inclusive urbanization processes are undertaken. Equal access to healthcare services would also be widely beneficial in the context of managing the COVID-19 pandemic.

Measuring COVID-19 Vaccination Coverage to Support Healthcare Equity Decision-Making in Urban Areas

“…Despite selecting high-priority centres for vaccination, the PSA rate in the proposed model was still high in some areas, including the centre and the areas surrounding the CBD. In contrast, the rates were close to zero in other areas due to the high concentration of health facilities in metropolitan areas, as seen in too many developing countries (52). Similar to the findings of Zhao et al (52) in Beijing , China, the public transportation system of our study area is unevenly distributed, with most transportation facilities (e.g., buses and metro stations) concentrated in the city centre.…”

“…In contrast, the rates were close to zero in other areas due to the high concentration of health facilities in metropolitan areas, as seen in too many developing countries (52). Similar to the findings of Zhao et al (52) in Beijing , China, the public transportation system of our study area is unevenly distributed, with most transportation facilities (e.g., buses and metro stations) concentrated in the city centre. According to Kenyon et al (53), the obstacles associated with transportation can worsen disparities in access to health facilities such as vaccination centres.…”

Integrating Socioeconomic Status and Spatial Factors to Improve the Accessibility of Community Care Resources Using Maximum-Equity Optimization of Supply Capacity Allocation

“…First, this study compensates for the limitations of previous studies, some of which took only spatial factors into consideration [40,47,57,58] or positioned population demand at the geometrically weighted center points of the population [18,47,48]. The limitations of exact locations of the population demand were addressed by using BSA data to solve problems of MAUP.…”

Transport Poverty in Chinese Cities: A Systematic Literature Review

“…Apart from jobs, accessibility to essential goods and services is also a problem for lower income people [27,38,66,67,84,[87][88][89][90]. These services include health services, education, shopping and physical activity facilities.…”

“…Longer travel times for these services may result in low satisfaction levels [66,89]. Among these services, poor access to medical facilities had a substantial impact on low-income households [37,39,90].…”