Exploring Equity in Healthcare Services: Spatial Accessibility Changes during Subway Expansion

Abstract

The unequal allocation of healthcare resources raises many fundamental problems, one of which is how to address inequity in population health. This paper focuses on disparities in public transport healthcare accessibility, with a special focus on an expanding subway system. Based on a vulnerability index, including factors that are likely to limit healthcare opportunities, a two-step floating catchment area method was used to assess the distribution of supply and demand for healthcare. Quantity, quality, and walking distance accessibility were aggregated into hexagonal grids. The Theil index was used to measure inequity and understand the influence of subways on spatial disparities in healthcare accessibility. The ongoing construction of the subway has heterogeneous impacts on healthcare accessibility for different parts of the city and exacerbates spatial inequity in many areas. In an environment where people in peri-urban areas are excluded from healthcare access because of low subway coverage, the results suggest that the potential for subways to address inaccessibility is limited. The findings highlight the requirement of efficient public transport services and are relevant to researchers, planners, and policymakers aiming to improve accessibility to healthcare, especially for populations who dwell in winter cities.