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

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

The Spatial Mechanism and Predication of Rural Tourism Development in China: A Random Forest Regression Analysis

Rural tourism has long been recognized as a significant strategy for promoting rural revitalization in China. Excessive development has had a number of negative consequences for rural tourism. As a result, there is a growing need to optimize the developmental framework of rural tourism in order to ensure its sustainable growth. This study focuses on key tourism villages and employs geostatistical analysis and the random forest methodology to elucidate the spatial mechanisms underlying rural tourism and identify potential areas for its development in China. The research findings reveal several important insights: (1) Key tourism villages exhibit a concentrated spatial distribution, characterized by pronounced regional disparities. (2) The intrinsic characteristics of rural areas and the conditions conducive to tourism development play pivotal roles in shaping rural tourism. Notably, cultural resources, tourism resources, rural accessibility, and tourism potential are identified as the primary influential factors. (3) Predictive modeling using random forest analysis indicates that densely populated areas in the eastern region retain the highest level of suitability for rural tourism. In contrast, the development of rural tourism in western and border regions encounters certain constraints. Additionally, the northern region encompasses larger expanses with high suitability, whereas the southern region is generally moderate. This comprehensive nationwide investigation provides valuable insights into the key aspects of rural tourism development and offers practical guidance for achieving sustainable rural tourism practices in China

Exploring Equity in a Hierarchical Medical Treatment System: A Focus on Determinants of Spatial Accessibility

It is essential to understand the spatial equity of healthcare services to achieve the Sustainable Development Goals. Spatial and non-spatial factors affect access to healthcare, resulting in inequality in the hierarchical medical treatment system. Thus, to provide a comprehensive equity evaluation, it is indispensable to investigate the extent to which spatial accessibility to healthcare services varies due to various factors. This study attempted to analyze the determinants of healthcare accessibility under multi-trip modes and integrate them into Theil index, as a demand index to evaluate spatial equity in the system. The results reveal an inadequate and inequitable distribution of healthcare resources. While access to primary hospitals is limited (47.37% of residential locations cannot access them on foot), 96.58% of residential locations can access general and tertiary hospitals via public transport or driving. Furthermore, inequitable access to the three-tiered medical system was evaluated on a more granular scale, with primary hospitals being closest to achieving equity (inequitable for only 48.83% of residential locations), followed by general and tertiary hospitals (82.01% and 89.20%, respectively). The unequal residential locations brought on by an abundance of medical resources are far from those with a shortage of resources (66.86% > 5.34%). It is thus suggested that services be expanded or resources be transferred to move toward a more equitable system. Our findings provide policymakers with insights into how to increase accessibility to public health