发表机构
Florida State University; University of Alabama（佛罗里达州立大学; 阿拉巴马大学）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
本研究通过佛罗里达狭长地带的多源纵向数据，量化乡村医疗可及性差距，并提出结合E2SFCA、利益相关者加权与约束部署的规划框架，以支持公平韧性规划。
AI 中文摘要
美国乡村社区面临持续的医疗保健差距，与非乡村社区相比，其医疗服务提供者和设施更少、就医路程更长、健康素养更低，交通和宽带基础设施也更薄弱。除任何单一障碍外，医疗可及性由服务的空间可及性、居民到达这些服务的能力、实际利用率以及当地系统在中断期间保持运转的能力共同决定，而这些因素通常被分开研究且空间尺度较粗，限制了其对社区规划的实用性。我们提出了一项针对佛罗里达州医疗可及性的细粒度、多源纵向测量研究，重点关注易受飓风影响的佛罗里达狭长地带。我们整合了医疗服务设施点、2018年1月至2021年4月的月度出行记录、人口普查区块组（CBG）级人口统计数据以及道路网络数据，从供给、出行、利用和韧性四个角度比较乡村与非乡村社区。我们发现，狭长地带95.57%的土地面积为乡村，且46.7%的乡村CBG在汇总清单中不包含任何医疗设施。乡村居民的人均设施可用性不到非乡村居民的一半。在人口统计调整后，这些差距依然存在，而纵向模式揭示了飓风迈克尔和COVID-19期间的大规模中断。基于这些证据，我们制定了一个可操作的规划框架，该框架结合了基于E2SFCA的可及性评估、利益相关者加权优先级排序，以及针对流动诊所、非紧急医疗运输、远程医疗和灾害韧性服务的约束部署模型。该研究展示了面向社区的空间智能如何支持乡村地区公平且韧性的医疗规划。
英文摘要
Rural communities in the United States face persistent healthcare disparities, with fewer providers and facilities, longer trips to care, lower health literacy, and weaker transportation and broadband infrastructure than their non-rural counterparts. Beyond any single barrier, healthcare accessibility is shaped jointly by the geographic availability of services, residents' ability to reach those services, realized utilization, and the capacity of local systems to remain operational during disruptions, which are often examined separately and at coarse spatial scales, limiting their usefulness for community planning. We present a fine-grained, multi-source longitudinal measurement study of healthcare accessibility in Florida, with a focus on the hurricane-prone Florida Panhandle. We integrate healthcare-facility points of service, monthly mobility records from January 2018 through April 2021, Census Block Group (CBG)-level demographic data, and road-network data to compare rural and non-rural communities from supply, travel, utilization, and resilience perspectives. We find that 95.57% of the Panhandle's land area is rural and that 46.7% of rural CBGs contain no healthcare facility in the pooled inventory. Rural residents have less than half the per-capita facility availability of non-rural residents. These disparities remain after measured demographic adjustment, while longitudinal patterns reveal substantial disruptions around Hurricane Michael and COVID-19. Building on this evidence, we formulate an actionable planning framework that combines E2SFCA-based access estimation, stakeholder-weighted prioritization, and constrained deployment models for mobile clinics, non-emergency medical transportation, telehealth, and disaster-resilient services. The study demonstrates how community-oriented spatial intelligence can support equitable and resilient healthcare planning in rural regions.
