Dynamic geographical accessibility assessments to improve health equity: protocol for a test case in Cali, Colombia

Luis Gabriel Cuervo; Ciro Jaramillo; Daniel Cuervo; Eliana Martínez-Herrera; Janet Hatcher-Roberts; Luis Fernando Pinilla; María Olga Bula; Lyda Osorio; Pablo Zapata; Felipe Piquero Villegas; Maria Beatriz Ospina; Carmen Juliana Villamizar

doi:10.12688/f1000research.127294.1

Dynamic geographical accessibility assessments to improve health equity: protocol for a test case in Cali, Colombia

F1000Res. 2022 Nov 28:11:1394. doi: 10.12688/f1000research.127294.1. eCollection 2022.

Affiliations

¹ Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
² School of Civil and Geomatic Engineering, Universidad del Valle, Cali, Valle del Cauca, Colombia.
³ IQuartil SAS, Bogotá D.C., 110111-300, Colombia.
⁴ Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Antioquia, Colombia.
⁵ WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment for Health Equity, Bruyère Research Institute, University of Ottawa, Ottawa, Ontario, K1R6M1, Canada.
⁶ Universidad de la Sabana, Bogotá D.C., Colombia.
⁷ Egis Consulting, Bogotá D.C., Colombia.
⁸ School of Public Health, Universidad del Valle, Cali, Valle del Cauca, Colombia.
⁹ Author of patobiography, Independent Patient Representative, Bogotá, D.C., Colombia.
¹⁰ Department of Public Health Sciences, Faculty of Health Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada.
¹¹ Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

This protocol proposes an approach to assessing the place of residence as a spatial determinant of health in cities where traffic congestion might impact health services accessibility. The study provides dynamic travel times presenting data in ways that help shape decisions and spur action by diverse stakeholders and sectors. Equity assessments in geographical accessibility to health services typically rely on static metrics, such as distance or average travel times. This new approach uses dynamic spatial accessibility measures providing travel times from the place of residence to the health service with the shortest journey time. It will show the interplay between traffic congestion, accessibility, and health equity and should be used to inform urban and health services monitoring and planning. Available digitised data enable efficient and accurate accessibility measurements for urban areas using publicly available sources and provide disaggregated sociodemographic information and an equity perspective. Test cases are done for urgent and frequent care (i.e., repeated ambulatory care). Situational analyses will be done with cross-sectional urban assessments; estimated potential improvements will be made for one or two new services, and findings will inform recommendations and future studies. This study will use visualisations and descriptive statistics to allow non-specialized stakeholders to understand the effects of accessibility on populations and health equity. This includes "time-to-destination" metrics or the proportion of the people that can reach a service by car within a given travel time threshold from the place of residence. The study is part of the AMORE Collaborative Project, in which a diverse group of stakeholders seeks to address equity for accessibility to essential health services, including health service users and providers, authorities, and community members, including academia.

Keywords: City planning; Health inequality monitoring; Health services accessibility; Residence characteristics; Spatial Analysis; Urban health.

MeSH terms

Colombia
Cross-Sectional Studies
Health Equity*
Health Services Accessibility
Humans
Travel

Associated data

figshare/10.6084/m9.figshare.20485404.v2

Grants and funding

IQuartil SAS received consulting fees to support the development of the advanced prototype of the AMORE Platform. The prototype of the AMORE Platform was developed as part of a collaboration between the principal investigator and Team33 during the Data Science for All (DS4A) training. No grants have been secured to support this project that the principal investigator has financed. Subsequent developments of the AMORE platform have not been considered part of the objectives or reach of the AMORE project.