Geographical accessibility of community social services and incidence of self-harm

Abstract

Objective: The study aimed to explore the association between area-based coverage of community services and the incidence of self-harm, which will provide an evaluation framework for the support of self-harm.

Methods: Enhanced two-Step floating catchment area method was used to estimate the centersto- population ratio and geographical accessibility adjusted by a distance-decay function. Spearman's rank coefficient was used to examine the association between the self-harm rate and adjusted accessibility index.

Results: There was a significant negative correlation between the accessibility index and selfharm rate in youth (rho = -0.87, P < 0.01) and older adults (rho = -0.87, P < 0.01). The survival curves showed no relationship between self-harm repetition and service accessibility in youth or older adults.

Conclusions: The uneven spatial accessibility of community social service centers and the independence between spatial accessibility and self-harm highlights the need to explore personal barriers to community service utilization.

Keywords: Accessibility; Hong Kong; Provider-to-population ratio; Self-harm.