Health-Related Disparities in the Metropolitan Region Ruhr: Large-Scale Spatial Model of Local Asthma Prevalence, Accessibility of Health Facilities, and Socioeconomic and Environmental Factors

Abstract

AbstractThis paper investigates the area of the Metropole Ruhr in terms of spatial distributions of environmental factors that can prevent or cause a significantly lower or higher rate of respiratory diseases such as asthma. Environmental factors can have negative impact, like air pollution, and positive, like the access to urban green areas. In the second part of the analysis, the accessibility of pharmacies, hospitals, and medical facilities that offer a special treatment for people with respiratory diseases will be spatially analysed and associated to those detected urban areas of higher and lower prevalence. The results of both approaches are spatially blended with socioeconomic and socio-demographic values of the respective residents. With this it is possible to point out whether accessibility of health facilities is a suitable and equitable for all people diagnosed with asthma regardless of their educational or migration background, their employment rate, salary or age. Consequently, all values will be disaggregated from large spatial units, such as city districts municipalities or neighbourhoods, to small city blocks, to assess large-scale spatial variability. This provides the opportunity of a point-by-point investigation and statistical analysis with a high level of detail that significantly exceeds previous study results. In the sociological context of environmental justice this highly interdisciplinary study contributes to the assessment of fair health conditions for people in densely populated conurbations.