Age Inequalities of Accessibility to Essential Urban Services. The Case Study of Primary Health Care in the City of Milan for Older People

Abstract

The population in urban areas is getting older because of a significant demographic change. In 2019, the OECD indicates that the share of people aged over 65 reached 17.8% and is expected to climb to 25.1% in 2050. Older people present age-associated limitations that influence mobility capacities with the occurrence of social isolation, loneliness, and depression. Moreover, aging is associated to an increased vulnerability and dependence on medical care services. Since everyone should have the opportunity to access to essential services equally, especially people who need them the most, to accomplish practices and maintain relationships that people take to be necessary for normal social participation. Hence, more age-friendly approaches are needed to shape ageing cities. In this study, a GIS-based procedure was developed in order to assess accessibility to primary healthcare services and to support decision-makers to better allocate resources, for local welfare policies restructuring. The accessibility measure considers the local healthcare provision, the land use structure and the characteristic of the multimodal transportation network. The methodology was applied to the city of Milan, considering its Health Protection Agency (ATS) that provides healthcare assistance to the elderly dwelling in the city. The outputs show that entire neighbourhoods’ elderly population suffers from very poor accessibility to primary health services, especially in the city suburbs, and that the methodology could be effective in urban planning strategies to promote better quality of life for the elderly.