Assessing the spatial burden in health care accessibility of low-income families in Rural Northeast Brazil

Abstract

Introduction:

This paper explores the spatial burden in healthcare accessibility of low-income families in rural Northeast Brazil. The Northeast region accounts alone for more than half (63%) of the population living in extreme poverty in Brazil and the majority of these people (57%) live in rural areas. To overcome the scarcity of geospatial data in such context, this study proposes an innovative proxy for tracking the location of the rural low-income households. Methods:

A dataset composed of the location of almost half a million cisterns provided by the Federal Government to low-income households of this region is evaluated in terms of accuracy and Euclidean distance to healthcare centres (Primary care, Emergency Care and Hospitals) by means of statistical and GIS tools. Results:

Evidence shows that such dataset, beyond having an inaccuracy of less than 105 m, is also substantially representative. The findings on healthcare accessibility show that 53.5% of the rural low-income population in Northeast Brazil are living farther than 5 km from the nearest Primary care centre and over 60% are at a distance greater than 10 km from the closest higher complexity healthcare centre (Hospitals and Emergency care units). Conclusions:

These results emphasise that the majority of this rural low-income population, who mostly live in a walking world (Porter, 2002), experience an insurmountable spatial burden preventing them from accessing public health services. It is argued that the availability of geo-location of low-income households registered in Social Programs (like the Cisterns Program) would enable a significant step forward in the Brazilian Transport and Public health planning. This study not only calls attention to the major hurdle faced by low-income families in Northeast Brazil but also offers a direction to where and for whom new transport and health interventions are particularly needed in the Latin American context.