Appraisal of urban-rural disparities in access to health care facilities and exposure to health risk factors: A case study of Durgapur Industrial region, India

Spatial health disparity is one of the least investigated public health issues in India. Quantifying disparity and balance between health risks and health-care access are the keys for identifying the areas under stress. This study is trying to assess the regional (urban, semi-urban, and rural) disparities in health-care access and health risk exposure around Durgapur industrial region to identify areas having higher risk factors and lesser health-care access. The study explores (1) rural-urban disparity of health-care accessibility (AHCF), (2) rural-urban disparity of health-risk exposures (HRE) and social status, and (3) identifying areas under stress by comparing AHCF and HRE. The study uses multidisciplinary techniques e.g. composite index, GIS and geostatistics interpreting numerous dimensions i.e. spatial coverage and adequacy of health care facilities (HCF), people's living standards, medical expenses, and exposure to health risk factors. We measured disparities with Quintile ratio, Sopher's Index, test of significance correlation coefficient and independent sample t-test. The study revealed significant correlations between AHCFs and urban population percentages, indicating that urban populations enjoy better AHCFs with dense HCFs distribution over space. As the proportion of urban population decreases, so does the density and serviceability of HCFs. Despite the proximity of urban areas to pollution sources, some of the rural areas are under more stress due to local geographical factors and possessing lower AHCF, social status and higher exposure to health risk factors. Environmental restoration and ceasing further economic development in Ranigunj, Jamuria, Mejhia blocks, and decentralisation of infrastructure towards north-eastern part (North Kanksa) are recommended.