1666597 - Regional Disparities of Access to Healthful Resources: Analyzing Perceived and Objective Measures

Strong relationships among perceived and objective accessibility to opportunities and the satisfaction that people derive from their neighborhood, their transportation options, and healthy choices have been identified in the literature. Previous research predominantly focused on urban settings, specific demographic groups (such as women and older adults), or specific ethnicities (like Hispanic and Asian populations). This limited scope has constrained our ability to draw comprehensive inferences about the intersectionality and variations within diverse population and area characteristics, especially across different levels of rurality.

To address this gap, our study leveraged a sample drawn from urban, suburban, large rural towns, and isolated rural areas across the United States. Our primary objective was to identify distinctions in perceived and objective accessibility to essential services, specifically focusing on healthy food providers, hospitals, and pharmacies. Survey participants provided self-reported data on the distances to the nearest service providers from their residences, reflecting their perceived accessibility. Additionally, secondary data sources enabled us to pinpoint the objectively nearest service providers, facilitating an approximation of objective access to these opportunities.

Our results revealed notable disparities between perceived and objective access across most geographic areas, with suburban and isolated rural respondents consistently showing no significant differences. In comparing perceived and objective access, we found that the disparity was most pronounced in the context of healthy food providers, as opposed to hospitals and pharmacies. Furthermore, our study identified a non-monotonic relationship between urban/rural classification and perceived and objective distances for all three types of opportunities. Surprisingly, respondents in suburban areas perceived and experienced greater distances to these opportunities than individuals residing in large rural towns, which, according to our classification criteria, are considered more rural.

Understanding the relationship between urban form and access to health-related opportunities is paramount for enhancing public health, addressing health disparities, encouraging active transportation, and gaining insights into the interplay between perceived and objective accessibility. This knowledge can serve as a valuable guide for urban planning and policy decisions to create healthier, more equitable, and accessible cities.