Inequalities In Access Research Articles

The Inequality in Healthcare Access in Bihar: Pattern and Determinants

Healthcare access varies across socioeconomic determinants and therefore, states’ demographic and socioeconomic structure plays an important role in an individual’s health status in the state. For example, richer have better access to healthcare than poorer, and women have lower healthcare access than men. In this study, the role of socioeconomic determinants in healthcare access is discussed in five states of India—Jharkhand, Uttar Pradesh, Odisha and Madhya Pradesh; therefore, this article aims to determine how healthcare access across socioeconomic determinants varies across states. The study is based on the National Sample Survey 75th round of data on health (2017–2018). A comparative study is conducted to know the percentage of non-access to healthcare (unmet needs) across different socioeconomic determinants such as age, gender, income, religion, caste and others. A logistic regression model is used to determine significant socioeconomic factors in healthcare access in all five states. The concentration index and concentration curve show the inequality in healthcare access across income quintiles. The result shows that Bihar has the highest cases of non-access to healthcare across most socioeconomic determinants followed by Odisha and Jharkhand. In addition, cases of non-access to healthcare in all five states are largely higher than the national average. The result further shows that only a few socioeconomic determinants such as income class and caste are significant to healthcare access and state-wise, they vary. JEL: I140; I150; I18

Becoming a thrombectomy-capable stroke center: Clinical and medico-economical effectiveness at the hospital level.

Too few patients benefit from endovascular therapy (EVT) in large vessel occlusion acute stroke (LVOS), and various acute stroke care paradigms are currently investigated to reduce these inequalities in health access. We aimed to investigate whether newly set-up thrombectomy-capable stroke centers (TSC) offered a safe, effective and cost-effective procedure. This French retrospective study compared the outcomes of LVOS patients with an indication for EVT and treated at the Perpignan hospital before on-site thrombectomy was available (Primary stroke center), and after formation of local radiology team for neurointervention (TSC). Primary endpoints were 3-months functional outcomes, assessed by the modified Rankin scale. Various safety endpoints for ischemic and hemorragic procedural complications were assessed. We conducted a medico-economic analysis to estimate the cost-benefit of becoming a TSC for the hospital. The differences between 422 patients in the PSC and 266 in the TSC were adjusted by the means of weighted logistic regression. Patients treated in the TSC had higher odds of excellent functional outcome (aOR 1.77 [1.16-2.72], p = 0.008), with no significant differences in the rates of procedural complications. The TSC setting shortened onset-to-reperfusion times by 144 min (95% CI [131-155]; p < 0.0001), and was cost-effective after 21 treated LVOS patients. On-site thrombectomy saves 10.825€ per patient for the hospital. Our results demonstrate that the TSC setting improves functional outcomes and reduces intra-hospital costs in LVOS patients. TSCs could play a major public health role in acute stroke care and access to EVT.

A system mapping activity to visualize lithium’s interconnectedness to societal and environmental aspects of the green energy transition

Abstract Lithium’s role in the global green energy transition provides an engaging context to visualize the interconnectedness of chemistry to seismic shifts taking place in society. Lithium has seen a dramatic increase in utilization, but given lithium’s current low rates of recyclability, this development is exacerbating the e-waste problem. Equally important, we posit that lithium extraction, from either brine or ore, and the associated impacts on the environment and local communities should not be so easily decoupled from the shift in human behaviors causing its demand. Presented here is a mapping activity that was trialed in professional learning workshops organized in New Zealand for secondary/high school chemistry teachers. In their mapping activity response, the teachers were able to connect typical school chemistry content (batteries, chemical processes) with environmental (planetary systems) and social, economic, and ethical considerations (useful products, unintended consequences, inequity in access to water) of the ongoing electrification of society. The teachers indicated a positive intention to utilize the activity, or one similar with a different chemical process or product, in their own classrooms. A school-ready version of the activity is provided in the supplementary information, which was revised based on feedback from the teachers attending the workshops.

Multi-method analysis of urban green space accessibility: Influences of land use, greenery types, and individual characteristics factors

Urban green spaces (UGS) are an important foundation for supporting sustainable urban development and benefiting the well-being of residents. However, access to green spaces is a complex and dynamic process. Existing studies have mainly used a single method to assess UGS accessibility, and research on influencing factors has less focused on a multi-variable perspective. In this study, we innovatively integrated four methods—Container, Distance, Gravity, and 2SFCA—to assess UGS accessibility at the LSOA level in Inner London. We examined the impact of urban land use patterns, green space types, and individual characteristics on UGS accessibility. Then, Spearman's correlation analysis and the Ordinary Least Squares (OLS) regression model were used to check the relationship between multiple variables with UGS accessibility. The main findings are as follows: (1) The UGS accessibility results based on the multi-method reflect the variation in the distribution of UGS in Inner London, with more than 80% of LSOAs having below-average UGS accessibility; (2) UGS accessibility is significantly influenced by multiple factors, particularly race, income, education, crime, office, residential, and non-park (multiple green space types beyond parks). This study highlights inequalities in UGS accessibility and suggests strategies for policymakers to improve the integration of UGS in urban planning.

Theoretical Perspectives Underpinning Research on the Physician-Patient Relationship in a Digital Health Practice: Scoping Review.

The advent of digital health technologies has transformed the landscape of health care, influencing the dynamics of the physician-patient relationship. Although these technologies offer potential benefits, they also introduce challenges and complexities that require ethical consideration. This scoping review aims to investigate the effects of digital health technologies, such as digital messaging, telemedicine, and electronic health records, on the physician-patient relationship. To understand the complex consequences of these tools within health care, it contrasts the findings of studies that use various theoretical frameworks and concepts with studies grounded in relational ethics. Using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review. Data were retrieved through keyword searches on MEDLINE/PubMed, Embase, IEEE Xplore, and Cochrane. We screened 427 original peer-reviewed research papers published in English-language journals between 2010 and 2021. A total of 73 papers were assessed for eligibility, and 10 of these were included in the review. The data were summarized through a narrative synthesis of the findings. Digital health technologies enhance communication, improve health care delivery efficiency, and empower patients, leading to shifts in power dynamics in the physician-patient relationship. They also potentially reinforce inequities in health care access due to variations in technology literacy among patients and lead to decreases in patient satisfaction due to the impersonal nature of digital interactions. Studies applying a relational ethics framework have revealed the nuanced impacts of digital health technologies on the physician-patient relationship, highlighting shifts toward more collaborative and reciprocal care. These studies have also explored transitions from traditional hierarchical relationships to mutual engagement, capturing the complexities of power dynamics and vulnerabilities. Other theoretical frameworks, such as patient-centered care, and concepts, such as patient empowerment, were also valuable for understanding these interactions in the context of digital health. The shift from hierarchical to collaborative models in the physician-patient relationship not only underscores the empowering potential of digital tools but also presents new challenges and reinforces existing ones. Along with applications for various theoretical frameworks and concepts, this review highlights the unique comprehensiveness of a relational ethics perspective, which could provide a more nuanced understanding of trust, empathy, and power dynamics in the context of digital health. The adoption of relational ethics in empirical research may offer richer insights into the real-life complexities of the physician-patient relationship, as mediated by digital technologies.

Getting it Just Right: Towards Balanced Utility, Privacy, and Equity in Shared Space Sensing

Low-cost sensors have enabled a wide array of data-driven applications and insights. As a result, encountering spaces with pervasive sensing has become all but unavoidable. This creates a fundamental tension: the success of smart environments will become increasingly dependent on equity of access to data-driven insights and consideration of the privacy expectations of sensed individuals. These concerns highlight the need to bring equity to all stakeholders of smart environments, which in turn would preserve public trust in these smart spaces. In this work, we explored several approaches to identity-obscuring visual representations through a progressive series of experiments. We designed and validated a series of visual representations through stakeholder interactions and tested the ability of these visual representations to limit identification via a crowdsourced study. An evaluation across three months of data gathered within our organization also showed that the identity-obscured data could still be leveraged to accurately count group size. Our contributions lay the groundwork for sensing frameworks that bring utility to all stakeholders of shared spaces while being cognizant of their diverse privacy expectations.

Toward Equity in Access to Midwifery: A Scan of Five Canadian Provinces

This research project was created to support equitable access to midwifery care for the diverse populations of Saskatchewan women. Given the ongoing implementation and expansion of midwifery across diverse mixes of rural, urban, and aboriginal communities in the health regions of the province, we asked: How can midwifery care be implemented in an equitable and accessible way in Saskatchewan? The first phase of this research explored experiences with midwifery implementation around issues of accessibility through an environmental scan of five Canadian provinces (British Columbia, Manitoba, Ontario, Northwest Territories, and Nova Scotia). By analyzing policy and regulatory documents together with primary data generated through key informant interviews, we discovered an interesting compendium of provincial activities and policies in support of equity to access midwifery. We also identified several important areas in need of strengthening. In this article, we present a brief description of the best practices identified by each province, followed by an exploratory analysis of key thematic issues that are significant in creating equitable access to the full scope of midwifery care. These included funding models, interprofessional relationships, choice of birthplace and second attendants, risk designation, geographic dispersal, community integration, and midwifery human resources.

Do physicians' attitudes toward prioritization predict poor-health patients' access to care?

Physicians often face tight resource constraints, meaning they have to make trade-offs between which patients they care for and the amount of care received. Studies show that patients requiring many resources disproportionately suffer a loss of care when resources are constrained. This study uncovers whether physicians' attitudes toward prioritization of healthcare predicts poor-health patients' access to care. We combine unique survey data on Danish GPs' preferred prioritization principle with register data on their patients' contacts in general practice. We consider different types of contacts as the required effort could impact the need for prioritization. Our results show variation in GPs' prioritization principles, where a majority prefers a principle that may lead to an unequal distribution of services. We further find that GPs' attitudes toward prioritization predict some poor-health patients' access to general practice. GPs who state they prefer the principle of prioritizing patients in the poorest health state when resources tightened provide more contacts to poor-health patients. The additional contacts are typically high-effort contacts such as annual status meetings and home visits, but also low-effort contacts such as emails. Our findings indicate inequity in poor-health patients' access to care across general practices.

Study protocol for a randomized controlled trial of supportive parents – coping kids (SPARCK)—a transdiagnostic and personalized parent training intervention to prevent childhood mental health problems

BackgroundTo meet the scientific and political call for effective prevention of child and youth mental health problems and associated long-term consequences, we have co-created, tested, and optimized a transdiagnostic preventive parent-training intervention, Supportive parents – coping kids (SPARCK), together with and for the municipal preventive frontline services. The target group of SPARCK is parents of children between 4 and 12 years who display symptoms of anxiety, depression, and/or behavioral problems, that is, indicated prevention. The intervention consists of components from various empirically supported interventions representing different theorical models on parent–child interactions and child behavior and psychopathology (i.e., behavioral management interventions, attachment theory, emotion socialization theory, cognitive-behavioral therapy, and family accommodation intervention). The content and target strategies of SPARCK are tailored to the needs of the families and children, and the manual suggests how the target strategies may be personalized and combined throughout the maximum 12 sessions of the intervention. The aim of this project is to investigate the effectiveness of SPARCK on child symptoms, parenting practices, and parent and child stress hormone levels, in addition to later use of specialized services compared with usual care (UC; eg. active comparison group).MethodsWe describe a randomized controlled effectiveness trial in the frontline services of child welfare, health, school health and school psychological counselling services in 24 Norwegian municipalities. It is a two-armed parallel group randomized controlled effectiveness and superiority trial with 252 families randomly allocated to SPARCK or UC. Assessment of key variables will be conducted at pre-, post-, and six-month follow-up.DiscussionThe current study will contribute with knowledge on potential effects of a preventive transdiagnostic parent-training intervention when compared with UC. Our primary objective is to innovate frontline services with a usable, flexible, and effective intervention for prevention of childhood mental health problems to promote equity in access to care for families and children across a heterogeneous service landscape characterized by variations in available resources, personnel, and end user symptomatology.Trial registrationClinicalTrials.gov ID: NTCT05800522

Bridging the Gap by Exploring Inequalities in Access to Land and Disparities in Agrarian Law in Indonesia

This article explores the historical underpinnings of unequal access to land in Indonesia, tracing its roots to colonial legacies and the lasting impact of Dutch colonial rule. Through an examination of laws such as the 1870 Agrarian Law, it highlights how indigenous peoples were systematically dispossessed of their land, exacerbating social inequality and perpetuating economic injustice. It also underscores the widespread legal uncertainty faced by marginalized groups, which hinders their access to essential services and deepens social and economic disparities. After the proclamation, Indonesia chose to create new regulations by passing Law No. 5/1960 on the Basic Regulation of Agrarian Principles (UUPA). This law became the legal framework for Indonesia's agrarian reform. Furthermore, this article explores the critical role of agrarian reform in reducing this disparity, advocating for comprehensive policy reforms that aim to strengthen legal protections for the land rights of marginalized communities. By elucidating the historical trajectory of land access inequality and its contemporary manifestations, this article contributes to a better understanding of the complex socio-legal dynamics that shape land tenure in Indonesia. Through a critical examination of colonial legacies and current policy frameworks, it seeks to inform efforts aimed at promoting social justice and equitable resource distribution. Ultimately, the article underscores the importance of agrarian reform that prioritizes the rights and welfare of marginalized communities, hoping to pave the way towards a more inclusive land governance regime and sustainable development. KEYWORDS : Land Access, Inequality, Agrarian Law, Agrarian Reform

Integration of primary care and palliative care services to improve equality and equity at the end-of-life: Findings from realist stakeholder workshops

Background: Inequalities in access to palliative and end of life care are longstanding. Integration of primary and palliative care has the potential to improve equity in the community. Evidence to inform integration is scarce as research that considers integration of primary care and palliative care services is rare. Aim: To address the questions: ‘how can inequalities in access to community palliative and end of life care be improved through the integration of primary and palliative care, and what are the benefits?’ Design: A theory-driven realist inquiry with two stakeholder workshops to explore how, when and why inequalities can be improved through integration. Realist analysis leading to explanatory context(c)-mechanism(m)-outcome(o) configurations(c) (CMOCs). Findings: A total of 27 participants attended online workshops (July and September 2022): patient and public members (n = 6), commissioners (n = 2), primary care (n = 5) and specialist palliative care professionals (n = 14). Most were White British (n = 22), other ethnicities were Asian (n = 3), Black African (n = 1) and British mixed race (n = 1). Power imbalances and racism hinder people from ethnic minority backgrounds accessing current services. Shared commitment to addressing these across palliative care and primary care is required in integrated partnerships. Partnership functioning depends on trusted relationships and effective communication, enabled by co-location and record sharing. Positive patient experiences provide affirmation for the multi-disciplinary team, grow confidence and drive improvements. Conclusions: Integration to address inequalities needs recognition of current barriers. Integration grounded in trust, faith and confidence can lead to a cycle of positive patient, carer and professional experience. Prioritising inequalities as whole system concern is required for future service delivery and research.

Effects of Mobi’s equity initiatives on public bike share access and use

Since its launch, Vancouver’s public bike share system has implemented changes to reduce barriers, enhance uptake, and make bike sharing more equitable. These include hiring an equity coordinator, expanding the service area, adding e-bikes to the fleet, reducing the age eligibility, reducing financial barriers through their Community Pass, and partnering with community organizations. We used a mixed methods study design to assess the impact of these initiatives on access to and use of public bike share. We found that the service area expansion reduced inequities in spatial access by socioeconomic status, age, and race, but higher socioeconomic status and white populations continue to have better access. Our analysis of system and survey data, and interviews with community organizations, revealed how the Community Pass is enhancing transport justice by expanding the benefits of bike share and improving access to opportunities for more diverse populations.

Toward Equity in Access to Midwifery in Saskatchewan: Key Informants’ Perspectives

In this article, we report on the second phase of our exploratory research into issues related to equity in access to midwifery in Saskatchewan. This phase of the research project aimed to explore equity in access to midwifery as understood and experienced by key stakeholders involved in the early stages of midwifery implementation in Saskatchewan. A total of 19 interviews were conducted with participants from Saskatchewan Health, the Midwifery Transitional Council, and Saskatoon’s Regional Midwifery Operations Committee, as well as practitioners, primary health care managers, directors from select regional health authorities, and Saskatchewan midwives. Additionally, all available midwifery policy documents and relevant Primary Health Care and Health Human Resource documents complemented the qualitative analysis. Initial thematic analysis led to five policy recommendations: (1) develop a provincial definition of “priority population” for midwifery clients, (2) establish a midwifery health human resource plan, (3) identify provincial midwifery research priorities, (4) facilitate growth in interprofessional relationships, and (5) develop a provincial “road map” for implementation. A secondary analysis of participants’ responses revealed concern over the poor public education about midwifery services and lack of provincial government prioritization, as well as varied perceptions of the concept of “equity.” We conclude that although general commitments to equity in midwifery service and access are enshrined in Saskatchewan’s health care policies and midwifery regulations, insider perspectives suggest that significant yet modifiable barriers to equity in access to care currently exist. This article has been peer reviewed

How to measure inequality of opportunity: The axial institutions index

The article presents a critical analysis of indices and indicators of gender equality and suggests a new comprehensive approach to measuring gender equality of opportunity within axial institutions, which are family, labor market, education, science, public and corporate governance. Whereas the main gender indices measure inequality of access to resources, the axial institutions index measures equality of opportunity using the concept of agency. The key innovations are as follows: the inclusion of the institution of family and the gender division of unpaid domestic work as the basis for gender inequality of opportunities; horizontal segregation in labor markets and in education by calculating the average gap in the share of women and men with different educational profile; inclusion of an institute of science, including academia decision-making, inclusion of an institute of corporate governance (along with the state one). As a result, the index of axial institutions is visualized in the form of a hexagon, which describes the specifics of the model of gender equality in Russia.

Analysis of The Feasibility of Hydrogen Injection in Pipeline Gas Challenges in The Management of Acute Myocardial Infarction in Patients With Associated Comorbidities: A Review of The Literature

Objective: The objective of this study is to investigate the challenges in the management of Acute Myocardial Infarction in patients with associated comorbidities, with the aim of identifying gaps in treatment and proposing strategies to improve care. Theoretical Framework: Modifiable risk factors play a significant role in the incidence of myocardial infarction, as evidenced by a relevant international study. Understanding the epidemiology of heart attack, including its prevalence, incidence and geographic distribution, is essential to develop effective prevention and control strategies. Identifying and managing traditional risk factors, such as smoking, hypertension, hyperlipidemia and obesity, is crucial in the preventive approach to this condition. Method: Through an integrative literature review, recent studies are explored that cover everything from epidemiology and risk factors to prevention and treatment strategies. An initial selection of 153 articles was refined to 10 studies that met all criteria. Results and Discussion: The results highlight an increasing trend in the prevalence of Coronary Artery Disease (CAD), with a stabilization in the age-standardized prevalence rate, suggesting advances in prevention and treatment. The analysis emphasizes the importance of robust and inclusive public health strategies, focused on educating the population about the risks, ensuring rapid access to treatment, and reducing inequalities in access to healthcare. Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how results can influence healthcare management, public policy formation, and clinical practice in cardiology. These implications may include the need for continuing education programs for healthcare professionals, the implementation of integrated care models, and the adaptation of healthcare systems to meet the specific needs of patients with comorbidities associated with AMI. Originality/Value: This study contributes to the literature by highlighting the specific challenges faced in the management of AMI in patients with comorbidities, providing valuable insights to improve the quality of AMI care and reduce disparities in treatment. The relevance and value of this research are evidenced by its contribution to a more comprehensive understanding of the factors that influence the prognosis and quality of life of these patients.

Determining the most appropriate socioeconomic status indicator for describing inequalities in dental visits by Japanese older people.

This study examined the association between various socioeconomic status (SES) indicators and dental visits among older Japanese. When examining health inequalities, an adequate indicator of SES should be applied. In older adults, wealth and pensions are considered more appropriate indicators of SES than education and income, but few studies have examined. This cross-sectional study used data from 12 391 individuals aged 65 years or older from the 2016 Japan Gerontological Evaluation Study (JAGES). The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were applied to examine the association of education, income, wealth and pensions with dental visits for treatment and check-up adjusting for covariates. The mean age of the participants was 74.0 ± 6.2 years. In the previous year, 56.3% of participants had visited a dentist for a check-up, and 65.9% had visited for treatment. Inequalities in dental treatment visits were observed for wealth, pensions and income rather than education. Income was not significantly associated with check-up visits. Wealth showed the largest association with dental visits for treatment [(SII 0.09, 95% CI 0.06 to 0.13), (RII 1.14, 95% CI 1.09 to 1.21)] and check-up [(SII 0.08, 95% CI 0.05 to 0.12), (RII 1.16, 95% CI 1.09 to 1.23)]. When measuring inequalities in access to dental care among the older population, wealth and pensions could be important indicators of SES.

An assessment of urban park accessibility using multi‐source data in Hefei, China: A social equity perspective

AbstractUrban parks are vital to enhance human well‐being and encourage sustainable urban development. However, the supply–demand match between the layout of urban parks and various social groups needs to be addressed. Therefore, this study quantitatively evaluates urban park accessibility using house‐level data from the social equity perspective in Hefei, China. A real‐time navigation route measurement based on the Amap application programming interface was taken advantage of to calculate green space travel time costs‐accessibility, and a combination of the Gaussian‐based two‐step floating catchment area method and measurement model to analyze supply–demand accessibility. On the other hand, housing price was used to indicate dwellers' socioeconomic status. The Gini coefficient, Lorenz curve, and bivariate correlation were adopted to explore the inequality of green space accessibility among residential communities. The results reveal a spatial inequality of green space between communities in the central portion of the Hefei and those in peri‐urban areas. We further found a spatial mismatch between green space resources and population distribution. At the same time, there is a significant correlation between green space accessibility and housing prices, which means the disadvantaged urban strata with low economic income face a supply shortage, while wealthier communities benefit more from green space accessibility. Hence, based on the evaluation results, the author proposes feasible optimization strategies for constructing urban parks in Hefei and can inform policy decisions regarding future park construction.

Global Inequalities in Access and Success in Higher Education

Despite its pivotal importance, the fundamental right to higher education remains far from universal, with inequalities in access to and success in higher education observed in almost all countries around the world. This article highlights some of the key inequalities that impede equitable access and success in higher education and outlines the diverse policy initiatives implemented by governments worldwide in their attempt to tackle this global challenge. It underscores the importance of elevating this issue as a global policy priority through collaborative, data-driven, innovative and comprehensive approaches.

Social inequality in skills: Exploring the moderating role of extracurricular activities related to socio‐economic differences in non‐cognitive and cognitive outcomes

AbstractEngaging in extracurricular activities is known to affect both cognitive and non‐cognitive outcomes, but there is social inequality in access to these activities. In this study, we examine the role of extracurricular activities in moderating the relationships between secondary school students' social background and their cognitive and non‐cognitive outcomes. Secondly, we examine variations in these relationships among three European cities that represent different educational systems in managing student heterogeneity. Based on the study findings, the effects of extracurricular activities on academic outcomes varied with regard to measured skills and the city of study. Extracurricular activities were related to enhanced interpersonal skills in all cities studied. However, in Turku and Ghent, extracurricular activities buffered the socio‐economic gradient in interpersonal skills, whereas in Barcelona, such activities increased it. Rather surprisingly, in all cities, engaging in extracurricular activities magnified the effect of socio‐economic status on cognitive skills.

Assessing Inequality in Urban Green Spaces with Consideration for Physical Activity Promotion: Utilizing Spatial Analysis Techniques Supported by Multisource Data

Urban green spaces (UGSs) play a significant role in promoting public health by facilitating outdoor activities, but issues of spatial and socioeconomic inequality within UGSs have drawn increasing attention. However, current methods for assessing UGS inequality still face challenges such as data acquisition difficulties and low identification accuracy. Taking Harbin as a case study, this research employs various advanced technologies, including Python data scraping, drone imagery collection, and Amap API, to gather a diverse range of data on UGSs, including photos, high-resolution images, and AOI boundaries. Firstly, elements related to physical activity within UGSs are integrated into a supply adjustment index (SAI), based on which UGSs are classified into three categories. Then, a supply–demand improved two-step floating catchment area (SD2SFCA) method is employed to more accurately measure the accessibility of these three types of UGSs. Finally, using multiple linear regression analysis and Mann–Whitney U tests, socioeconomic inequalities in UGS accessibility are explored. The results indicate that (1) significant differentiation exists in the types of UGS services available in various urban areas, with a severe lack of small-scale, low-supply UGSs; (2) accessibility of all types of UGSs is significantly positively associated with housing prices, with higher-priced areas demonstrating notably higher accessibility compared to lower-priced ones; (3) children may be at a disadvantage in accessing UGSs with medium-supply levels. Future planning efforts need to enhance attention to vulnerable groups. This study underscores the importance of considering different types of UGSs in inequality assessments and proposes a method that could serve as a valuable tool for accurately assessing UGS inequality.