University of Oulu

Kotavaara, O., Nivala, A., Lankila, T., Huotari, T., Delmelle, E., & Antikainen, H. (2021). Geographical accessibility to primary health care in Finland – Grid-based multimodal assessment. In Applied Geography (Vol. 136, p. 102583). Elsevier BV.

Geographical accessibility to primary health care in Finland : grid-based multimodal assessment

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Author: Kotavaara, Ossi1; Nivala, Aleksi2; Lankila, Tiina1;
Organizations: 1University of Oulu, Finland
2Finnish Environment Institute (SYKE), Finland
3University of North Carolina, United States
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 9.8 MB)
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Language: English
Published: Elsevier, 2021
Publish Date: 2021-10-20


Geographic accessibility of health services is one of the key dimensions affecting health care access, utilisation and may impact population health. We analysed countrywide space-time accessibility to primary health services by private car and multimodal walk-ride-walk travel chains of public transport in Finland. The analysis utilises register-based population grid cell data at 250m × 250 m resolution, road network with scheduled public transport data and geocoded locations of four types of primary health service. Our results show that the Finnish population reaches primary health services well, also by public transport, which is most beneficial in urban fringes, where health services are not immediately available. However, accessibility of services may be limited for some segments of the population, such as carless households located in remote areas, and teenagers who access health services independently. Distinct regional differences exist in accessibility, particularly in rural areas. The continuous pressure to reduce the number of service facilities may further deter service accessibility of these segments of the population. As this kind of transport disadvantage may create or reinforce social disadvantage and exclusion, as well as health inequalities, ensuring an equal access to primary health services is important.

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Series: Applied geography
ISSN: 0143-6228
ISSN-E: 1873-7730
ISSN-L: 0143-6228
Volume: 136
Article number: 102583
DOI: 10.1016/j.apgeog.2021.102583
Type of Publication: A1 Journal article – refereed
Field of Science: 113 Computer and information sciences
3142 Public health care science, environmental and occupational health
519 Social and economic geography
Funding: This study is a part of the consortium project “Improving the Information Base and Optimising Service Solutions to Support Social Welfare and Healthcare Reform (IMPRO)”. The research was funded by the Strategic Research Council at the Academy of Finland, funding decision numbers 312703, 312704, 312705, 336325, 336326 and 336327.
Academy of Finland Grant Number: 312705
Detailed Information: 312705 (Academy of Finland Funding decision)
336327 (Academy of Finland Funding decision)
Copyright information: © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (