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

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 x 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.