Xu Zhenhua, Chang Jiaying, Han Cong
School of Urban Construction, Beijing City University, Beijing, China.
Shenzhen International Graduate School, Tsinghua University, Beijing, China.
Front Public Health. 2025 Apr 28;13:1563750. doi: 10.3389/fpubh.2025.1563750. eCollection 2025.
With China's rapid urbanization and aging population, ensuring equitable access to essential facilities in Community Health Service Centers (CHSCs) is critical for delivering primary healthcare to older adults. These centers serve as the frontline for managing chronic diseases, promoting healthy aging, and reducing healthcare disparities among the older adults. This study investigates the equity of CHSCs across eastern, central, and western regions of China using indicators of cyclability and walkability, both of which are essential for older populations who often rely on active travel modes due to physical or economic limitations. A total of 110 nationally ranked CHSCs were selected for analysis. Geographic Information System (GIS) technology was used to assess cyclability, defined by a 1,000-meter residential area coverage, and walkability, represented by the average Walk Score. Results show that the cyclability scores for the eastern, central, and western regions were 0.71, 0.64, and 0.46, respectively, below the national standard of a 3,000-meter service radius, highlighting insufficient cycling access to primary care for older residents. Walkability scores were 0.351, 0.388, and 0.287, with lower values, particularly concerning aging populations with limited mobility. These findings reveal pronounced regional disparities and point to the need for spatial optimization of CHSCs, increased facility provision, and targeted resource allocation to western regions. By enhancing the active accessibility of community healthcare services, particularly for older adults, this research provides policy-relevant evidence to advance equity, promote healthy aging, and support sustainable public health planning in China.
随着中国城市化的快速发展和人口老龄化，确保社区卫生服务中心（CHSCs）基本设施的公平可及性对于为老年人提供初级医疗保健至关重要。这些中心是管理慢性病、促进健康老龄化以及减少老年人医疗差距的前沿阵地。本研究使用可达性和步行便利性指标，对中国东部、中部和西部地区的社区卫生服务中心的公平性进行了调查，这两个指标对于因身体或经济限制而经常依赖主动出行方式的老年人群体来说都至关重要。总共选取了110家全国排名靠前的社区卫生服务中心进行分析。利用地理信息系统（GIS）技术评估可达性（以1000米居民区覆盖范围来定义）和步行便利性（以平均步行得分来表示）。结果显示，东部、中部和西部地区的可达性得分分别为0.71、0.64和0.46，低于3000米服务半径的国家标准，这凸显了老年居民前往初级保健机构的骑行可达性不足。步行便利性得分分别为0.351、0.388和0.287，得分较低，这对于行动不便的老年人群体尤其值得关注。这些发现揭示了明显的地区差异，并表明需要对社区卫生服务中心进行空间优化、增加设施供应以及有针对性地向西部地区分配资源。通过提高社区医疗服务的主动可达性，特别是针对老年人，本研究提供了与政策相关的证据，以促进公平、推动健康老龄化并支持中国可持续的公共卫生规划。
