Spatial Accessibility to Primary Healthcare Services by Multimodal Means of Travel: Synthesis and Case Study in the City of Calgary

Int J Environ Res Public Health. 2019 Jan 9;16(2):170. doi: 10.3390/ijerph16020170.


Universal access to primary healthcare facilities is a driving goal of healthcare organizations. Despite Canada's universal access to primary healthcare status, spatial accessibility to healthcare facilities is still an issue of concern due to the non-uniform distribution of primary healthcare facilities and population over space-leading to spatial inequity in the healthcare sector. Spatial inequity is further magnified when health-related accessibility studies are analyzed on the assumption of universal car access. To overcome car-centric studies of healthcare access, this study compares different travel modes-driving, public transit, and walking-to simulate the multi-modal access to primary healthcare services in the City of Calgary, Canada. Improving on floating catchment area methods, spatial accessibility was calculated based on the Spatial Access Ratio method, which takes into consideration the provider-to-population status of the region. The analysis revealed that, in the City of Calgary, spatial accessibility to the primary healthcare services is the highest for the people with an access to a car, and is significantly lower with multimodal (bus transit and train) means despite being a large urban centre. The social inequity issue raised from this analysis can be resolved by improving the city's pedestrian infrastructure, public transportation, and construction of new clinics in regions of low accessibility.

Keywords: multimodal network; primary healthcare; spatial accessibility.

MeSH terms

  • Canada
  • Catchment Area, Health
  • Health Services Accessibility / statistics & numerical data*
  • Healthcare Disparities
  • Humans
  • Primary Health Care / statistics & numerical data*
  • Transportation / methods*
  • Transportation / statistics & numerical data
  • Urban Health