Analysing spatial accessibility to health care: a case study of access by different immigrant groups to primary care physicians in Toronto

Abstract

This article analyses the spatial accessibility of a number of immigrant groups to linguistically diverse primary care (family) physicians in the Toronto Census Metropolitan Area (CMA). The two-step floating catchment area (2SFCA) method, a special type of gravity model, is employed to measure spatial accessibility using Network Analyst in ArcGIS 9.3. The context of this study is the predominantly publicly funded Canadian health-care system and a multicultural urban setting where both the population and the physicians are culturally and linguistically diverse. This article focuses on a total of eight ethnicities: six groups of recent immigrants – from Hong Kong, Iran, Mainland China, Pakistan, Russia and Sri Lanka; and two groups of long-standing immigrants – from Italy and Portugal. It examines the spatial (mis)match between the residential distribution of immigrant populations and the distribution of linguistically appropriate family physicians. The quantitative data analysed in this article include the physician data set from the College of Physicians and Surgeons of Ontario and geo-referenced 2006 Canadian Census data. This article highlights areas of poor accessibility and provides a comparison of the different ethnic groups. It demonstrates the use of the geographical information system (GIS) in public health research and yields important policy implications for public health planning.