Horizontal and vertical inequity of multi-modal healthcare accessibility in the aging Japan in the post-COVID era: a GIS-based approach

Evaluating the inequity of healthcare accessibility across demographic groups in the post-COVID era is of critical importance for an aging society like Japan – it helps to achieve better social equity via distributing healthcare resources in health planning and policy making. Our study contributes to the first post-covid evaluation of multi-modal healthcare accessibility in Tokyo, Japan, the most populated metropolis in the world. A further novelty goes to the multi-dimensional examination of the inequity of healthcare accessibility (i.e. hospitals) by public transit, driving and walking – the horizontal inequity across urban space and the vertical inequity across three demographic groups (the young, adult and elderly) through network analysis, spatial accessibility analysis and inequity indexing. We find that low healthcare access areas mainly appear in the peri-urban space as well as regions less covered by public transit. Compared to the adult group, the elderly group experiences significant inequity of healthcare access particularly in the peri-urban areas where driving is the dominant transport mode to access healthcare facilities. We provide timely evidence to the Japanese government and health authorities to have a holistic and latest understanding of multi-modal healthcare access across different demographic groups in the post-COVID era.