Promote Health Equity Research Articles

Sleep disturbances among older adults from the Russian Far East experiencing social loss: is there a sex difference?

BackgroundMaintaining sleep health in the elderly is of great significance for promoting health equity. The elderly usually experience more social losses, which may lead to many health problems. Few studies have revealed the relationship between social losses and sleep disturbance in the elderly. This study aims to investigate the relationship between social losses and sleep disturbance in the elderly in Russia, and further explore whether the buffering effect of social interaction on relationships has sex differences.MethodsA total of 331 elderly participants from Vladivostok, Russia, were analyzed. Binary logistic regression analysis was performed to explore the factors associated with sleep disturbances. Based on participants’ social loss and social interaction, participants were divided into four groups: (i) no social loss + social interaction, (ii) no social loss + no social interaction, (iii) social loss + social interaction, and (iv) social loss + no social interaction. Binary logistic regression was also conducted to examine the interaction between social loss and social interaction on sex-stratified sleep disturbances.ResultsSocial loss among older Russian adults was associated with sleep disturbance in both males and females in the sample collected in this study. Female participants who engage in social interaction showed a significant reduction in the risk of sleep disturbances when experiencing social loss. However, no significant association was observed between social interaction and sleep disturbances among male experiencing social loss.ConclusionsOur findings emphasize that social loss is a risk factor for sleep disturbances, while social interaction serves as a buffering factor for sleep disturbances in elderly females experiencing social loss. This suggests that providing targeted support for elderly individuals of different sexes who have experienced social loss may be an equitable and effective approach to improving sleep health among the elderly in the Russia Far East.

Geographical distribution and the impact of socio-environmental indicators on incidence of Mpox in Ontario, Canada.

Ontario, being one of Canada's largest provinces, has been central to the high incidence of human Mpox. Research is scarce on how socio-environmental factors influence Mpox incidences. This study seeks to explore potential geographical correlations and the relationship between indicators of social marginalization and Mpox incidence rate in Ontario. We used surveillance data on confirmed human Mpox cases from May 1, 2022, to March 31, 2024, extracted from the Public Health Ontario website for this study. Spatial autocorrelation of Mpox incidence was investigated using spatial methods including Moran's Index, Getis-Ord Gi*statistic, and spatial Poisson scan statistic. Following this, we adopted a generalized Poisson regression (GPR) model to estimate the incidence rate ratios (IRRs) based on the association between Ontario PHU-level marginalization and Mpox incidence, while adjusting for age and sex. The goodness-of-fit of the models was assessed using the Log Likelihood (LL), Akaike Information Criterion (AIC), Akaike's Information Criterion corrected (AICc), and the Bayesian Information Criterion (BIC). Our analysis revealed significant localized spatial heterogeneity in Mpox incidence across Ontario. Statistically significant local clusters of Mpox cases were identified in Toronto ([Formula: see text] ), Ottawa ([Formula: see text]), and a secondary cluster, overlapping Hamilton PHU with nine local districts ([Formula: see text]), all with [Formula: see text]. The incidence rate of Mpox was statistically significantly associated with a higher proportion of ethnic concentration (racialized groups, migrants, or visible minorities) [Formula: see text], gender [Formula: see text] and higher residential instability [Formula: see text]. We identified major Mpox hotspots in Toronto. According to our model results, the high incidence rate may be influenced by the greater population of internal migrants and younger individuals. Based on these insights, we recommend targeted interventions in the high-risk neighborhoods. Efforts to improve Mpox diagnosis and promote health equity among socioeconomically vulnerable populations, including racial and ethnic minorities, should be implemented.

Local healthcare resources associated with unmet healthcare needs in South Korea: a spatial analysis.

Despite national initiatives to enhance healthcare accessibility, unmet healthcare needs in South Korea remain notably high, particularly in specific regions. This study investigated the factors contributing to geographical disparities in unmet healthcare needs by employing spatial regression models to examine the spatial interactions between healthcare resources and unmet needs. Utilizing data from the 2020 Community Health Survey and Statistics Korea for 216 local government entities, excluding remote areas to ensure data consistency, we identified significant spatial clusters of unmet healthcare needs. These clusters are primarily located in non-metropolitan regions facing transportation barriers and limited healthcare infrastructure. Spatial regression analysis revealed that general hospitals and clinics are significantly associated with reduced unmet healthcare needs underscoring their critical role in mitigating regional disparities. In contrast, hospitals (≥30 beds) and convalescent hospitals did not exhibit significant effects, likely owing to their focus on specialised inpatient and long-term care services, which do not directly address immediate outpatient needs. These findings advance the understanding of how healthcare resource distribution impacts unmet needs at a regional level in South Korea and highlight the necessity for allocating general hospitals and clinics strategically to promote health equity. Based on these results, we recommend evidence- based policy interventions that optimise existing healthcare resources and strategically deploy new facilities in underserved regions. These insights provide valuable guidance for policymakers to reduce geographical health disparities and enhance overall public health outcomes.

"She's Always Made Sure That We Had Black Doctors, Particularly Women Doctors If We Could… and How It Can Sometimes Be the Difference Between Life and Death." Black College Women's Reflections On Medical Racism As a Social Determinant of Health.

Historical instances of medical racism and the impact of ongoing disparities are an understudied determinant of Black women's sexual health. Here, we use a Black feminist approach to engage Black women in a qualitative exploration of the impact of medical racism on their health-related decision-making. Specifically, we explore the question, how does exposure to information on medical racism impact Black women today and inform their perceptions of healthcare? This qualitative study uses Black feminist approaches to study design including advisory boards, interviewer concordance, and focus group data collection with Black female college students who were in the developmental phase of emerging adulthood, ages 18-25. We also led seven virtual focus groups that focused on dialogue around agents of sexual socialization including knowledge of historical and ongoing medical racism. Four themes emerged from our thematic analysis. The first theme was compromised mental health. The second theme was a wealth and health paradox whereby income and education did not mitigate the impact of racism on health. The third theme was medical racism and distrust. And the fourth theme was around the role of Black Americans as guinea pigs, autonomous actors, and advocates in healthcare. Medical racism, whether it is experienced firsthand, vicariously, or as a part of one's history, is a source of anxiety for Black women. This barrier to care must be addressed to promote health equity in the USA.

Examining the Influence of Food Insecurity on Perinatal Health Outcomes Among Black Birthing Individuals in the U.S.: A Systematic Scoping Review.

Food insecurity disproportionately affects Black households in the United States (US) and is linked to adverse perinatal health outcomes. Addressing food insecurity is crucial for improving maternal and infant health outcomes, especially among Black mothers. This scoping review explores the impact of food insecurity and low food access (i.e., food deserts) on various maternal health outcomes during the perinatal period among Black women. Using the Joanna Briggs Institute guidelines for scoping reviews, literature searches were conducted in PubMed, CINAHL, and Web of Science databases from January 2013 to January 2023. Eligible studies focused on Black women in the US experiencing food insecurity and reporting maternal health outcomes. Of 154 initially identified studies, nine met the inclusion criteria. Findings reveal diverse associations between food insecurity and perinatal outcomes among Black women, including gestational diabetes, breastfeeding practices, and maternal anemia. While some studies demonstrated direct links, others explored stressors associated with food insecurity during pregnancy. The current literature suggests that food insecurity exacerbates health disparities among Black birthing individuals, contributing to adverse perinatal health outcomes. Addressing food insecurity is crucial for improving maternal health equity. It is recommended that food insecurity screening and tailored support services be integrated into prenatal care services. To promote health equity, public health policies should prioritize interventions targeting food insecurity among Black birthing individuals and communities. Collaborative efforts between legislators, providers, educators, researchers, and communities are needed to implement comprehensive interventions addressing the systemic inequities from which food insecurity stems, to achieve health and nutritional equity for all birthing individuals.

An environmental vulnerability index framework supporting targeted public health interventions at the census tracts level.

Analyzing and visualizing disparities in environmental risks can help assess place-based vulnerabilities and provide civic leaders and community members with essential data for promoting health equity and informing public health strategies. We investigated the adaptation of a previously developed environmental vulnerability index to evaluate the cumulative impact of diverse stressors in Louisville Metro-Jefferson County, KY, with the goal of supporting multi-faceted targeted public health interventions at the census tract level. We assessed countywide vulnerability variability using the Toxicological Prioritization Index interface across five domains with 32 publicly available data indicators, and modeled the effects of theoretical public health interventions. Our findings suggest that similar vulnerable areas are not always geographically clustered. Higher vulnerability scores were observed in the western and central areas of the county, with lower scores in the eastern regions. The index enabled the selection of the most at-risk census tracts for modeling targeted public health interventions to reduce cumulative environmental vulnerability. Environmental vulnerabilities are not invariant features of urban environments. Rather, knowledge of these risks can guide the development and implementation of targeted solutions. This analysis demonstrated how publicly available data can support selection of feasible interventions to improve environmental equity. Targeted interventions to modify environmental conditions that support health can be developed and implemented locally with greater precision at the census tract level, yielding impactful outcomes.

Critical analysis of interprofessional student-led community health promotion workshops.

Health promotion interventions can empower communities and individuals by focusing on social and environmental interventions, rather than on individual behaviour changes. The settings-based approach, rooted in WHO's Health for All initiative, emphasizes community involvement, collaboration, and equity. Community-based health promotion, especially in rural and remote areas where there is a higher proportion of underserved populations, can leverage community assets and promote health equity. Student-led health promotion initiatives are gaining traction, benefiting both students and communities. Reach Accès Zhibbi (RAZ), a student-led organization in Sudbury, Ontario in Canada delivers evidence-based health promotion workshops to vulnerable populations, promoting health literacy and equity. This study examines the impact of RAZ's workshops, addressing a gap in research on student-led, non-clinical health promotion efforts. This cross-sectional mixed-methods study examined RAZ workshops at five partnering community agencies. Data was collected with two surveys: a web-based survey for staff and a paper-based survey for workshop participants. The first gathered perspectives on long-term impacts of the workshops, while participant surveys were given before and after the workshops to assess baseline knowledge, learning, and behavioural intent. The surveys were developed using the Health Behaviour Scale-16 and were designed at a grade 5 reading level for accessibility. Data analysis involved frequency analysis and Wilcoxon signed-rank test to assess perceived learning gains. Thematic analysis was conducted on qualitative data. Seven employees from three of the five partnering agencies rated the effectiveness of RAZ workshops, with a mean score of 9 out of 10. They highlighted benefits such as increased knowledge, skills, and mental wellness. Thematic analysis identified three key themes: long-term impact, practical application, and mutual collaboration. Among 33 workshop participants, significant improvements were observed in health literacy, decision-making, and physical and mental health knowledge post-workshop. A Wilcoxon signed-rank test on adjusted change scores for pre- and post-workshop data revealed statistically significant gains in perceived learning across all aspects. Most attendees found the workshop helpful, with 57.6% planning behaviour changes. This study showed that interprofessional student-led health promotion workshops effectively enhance health literacy and empower underserved communities. Significant improvements in participants' knowledge and confidence suggest these workshops help address health disparities. The findings highlight their potential scalability and adaptability across communities, promoting sustainable health promotion efforts, an important consideration for rural and remote communities.

Promoting mental health equality by investing in organizations: lessons from implementation science

Purpose Mental health inequalities based on race and ethnicity in the USA and globally persist despite efforts to address them. The COVID-19 epidemic accentuated these inequalities and demonstrated the extent to which they are linked to social determinants. However, the organizations that are best placed to ameliorate mental health inequalities are often underfunded and under-resourced. Investment strategies that restrict funding for programmatic costs rather than general operating costs often disproportionately impact small organizations that serve communities of color. This study aims to argue that effectively addressing mental health inequalities requires investing in these organizations by applying the lessons learned from implementation science. Findings This study demonstrates how organizational factors such as leadership, supervision and organizational culture and climate are key to programmatic success and how implementation strategies can target these factors. As promoting health equity is increasingly recognized as a priority outcome for implementation science research, these organizational approaches can inform funders on how to support small organizations that serve marginalized communities, giving them the capacity and flexibility to address mental health inequalities. Originality/value This paper applies the findings from implementation science to consider how best to support mental health organizations, particularly those well suited to serving the mental health needs of diverse communities.

Boston prevention provider helps immigrants deal with current crisis

It wasn't what they were meant to do originally, but recently, the East Boston Neighborhood Health Center has found new work in helping people who need it. Nancy Slamet, Director of the East Boston Alliance for Support, Treatment, Intervention and Education (EASTIE) Coalition, works with the center on outreach for community members and promoting health equity, because 60–70% of the population is from Latin America.

Optimizing Resource Allocation for Malaria Control in Rural Uganda: Challenges and Opportunities

Malaria remains a significant public health challenge in rural Uganda, where healthcare access is limited, and the disease poses severe economic and social burdens. This review explores the complexities of resource allocation for malaria control in these underserved areas, identifying key challenges such as inadequate funding, weak healthcare infrastructure, human resource constraints, and inefficient resource distribution. The review also highlights opportunities to optimize resource allocation through innovative financing models, capacity building, community engagement, and the integration of digital health technologies. By examining case studies, successful interventions, and actionable strategies, the review underscores the importance of targeted and evidence-based resource allocation to achieve malaria elimination and promote health equity in Uganda. The findings aim to guide policymakers, healthcare providers, and stakeholders in addressing disparities and improving the effectiveness of malaria control efforts in rural communities. Keywords: Malaria control, Resource allocation, Rural healthcare, Uganda, Public health challenges.

A National Study Among Diverse US Populations of Exposure to Prescription Medications with Evidence-Based Pharmacogenomic Information.

Tailoring pharmacogenomic (PGx) implementation to diverse populations is vital to promoting health equity. We assessed prescriptions for medications with potentially actionable PGx information to identify patient characteristics associated with differential PGx medication exposure. We analyzed the nationally-representative MEPS dataset of adults who reported receiving prescriptions between 2014 and 2021. PGx medications include those the FDA and CPIC designate as having drug-gene associations supported by scientific evidence. With the primary outcome being PGx prescriptions, we performed Poisson regression adjusted for all other relevant covariates. In our final population (N = 119,722, 72% White/20% Black/4% Asian/8% Hispanic), 61% were prescribed a PGx medication, 56% were female, and 97% held health insurance coverage. Adults with private health insurance (65%) or public Medicaid/Medicare coverage (32%) were more likely to have PGx prescriptions than the uninsured (3%). Individuals with cardiovascular conditions [adjusted IRR (aIRR) = 1.45, 95% CI 1.41, 1.48], high cholesterol [aIRR = 1.37, 95% CI 1.35, 1.40], high blood pressure [aIRR = 1.14, 95% CI 1.12, 1.16], and cancer [aIRR = 1.02, 95% CI 1.00, 1.04] were more likely to receive PGx prescriptions. Self-reported Blacks were less likely than Whites to receive PGx medications [aIRR = 0.92, 95% CI 0.90, 0.94], and among those with health conditions, the likelihood of PGx medication exposure for underrepresented groups (Blacks, Hispanics, and Asians) was lower than for Whites. Our study using a comprehensive list of PGx medications in a nationally representative dataset indicates that certain populations are differentially exposed to genomically informed medications. This may suggest that if implementing a pharmacogenomics program based on reactive testing initiated by a prescription, a small underrepresentation of the Black population could be expected because of an underlying prescription disparity. Secondly, if implementing a pharmacogenomics program based on targeted preemptive testing, using clinical indication/comorbidity may be a reasonable way to enrich the population for prescriptions that would benefit from genotype tailoring.

The Pedagogical Potential of Affective Oral Histories: A Case Study of Student Interviewer Testimonies in the Health and Human Rights Oral History Project

ABSTRACT The Health and Human Rights Oral History Project (HHROHP) is a growing collection of video testimonies from diverse figures in the health and human rights movement, organized and overseen by the Institute of Inequalities in Global Health at the University of Southern California (USC IIGH). This article is part of an ongoing collaboration between USC IIGH and the University of the Witwatersrand, Johannesburg, to review the methodology of the pilot phase and consider its expansion as a new resource for teaching and research. In foregrounding the testimonies of the three student interviewers who had been involved in the pilot phase of the HHROHP, this article argues that cataloging student interviewers’ perceptions and reflections has embedded an additional primary source within the HHROHP archives, which can—and should—be used to engage with the subjectivity of the interviewer and the process of creating and curating archival collections. In engaging with the students’ reflections, it is clear that their personal perspectives and professional trajectories had been meaningfully affected by their involvement. The resulting sense of personal responsibility felt among the HHROHP’s student interviewers toward the promotion of health equity and justice work more broadly offers interesting implications for the employment of oral history in furthering the aims of the contemporary health and human rights movement, which this article aims to investigate.

Social Determinants and Quality of Life in Food Allergy Management and Treatment.

Social Determinants and Quality of Life in Food Allergy Management and Treatment.

Environmental Sustainability and Cancer Imaging.

Environmental Sustainability and Cancer Imaging.

Addressing systemic racism and its influence on health disparities through a foundational pharmacy course and a student-led symposium.

Addressing systemic racism and its influence on health disparities through a foundational pharmacy course and a student-led symposium.

The Intersection of Health and Planet: Why Food Choices Matter.

Objective: To explore the interconnected crises of chronic disease, environmental degradation, and social inequity through the lens of food systems and to highlight the potential of plant-based dietary patterns to mitigate these challenges. Main Outcomes and Measures: Evidence demonstrates that plant-based diets reduce the prevalence of chronic diseases, including heart disease and type 2 diabetes, alleviate environmental harm by reducing greenhouse gas emissions and water usage, and promote health equity by increasing access to affordable, nutritious foods. Quantitative outcomes include projected savings of trillions of dollars in health care and climate-related costs and the prevention of millions of premature deaths globally. Results: Transitioning to plant-forward food systems has been associated with a reduction in chronic disease risk by up to 90%, a significant decrease in health care expenditures, and a 75% reduction in agricultural land use. Key interventions, such as produce prescriptions and plant-based meal programs, demonstrate the effectiveness of systemic solutions in improving health outcomes while addressing structural inequities. Conclusion: Aligning individual and collective efforts toward sustainable, health-focused food systems presents a transformative opportunity to improve global health, conserve natural resources, and foster social equity. By adopting plant-based diets and supporting equitable food policies, individuals, health care professionals, and policymakers can collaboratively create a more resilient, sustainable, and just future for generations to come.

Barriers to healthcare services utilisation among women in Ghana: evidence from the 2022 Ghana Demographic and Health Survey

BackgroundAccess to healthcare is vital to women's health outcomes, as emphasised in the Sustainable Development Goals. This study aimed to assess the factors associated with barriers to healthcare utilisation among women aged 15-49 years in Ghana.MethodsData from the 2022 Ghana Demographic and Health Survey was used for the study. The study included 15,014 women. Regional variations in the proportion of respondents with healthcare access were visualised using a spatial map. A multivariable binary logistic regression analysis was conducted. The results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).ResultsIn Ghana, 53.6% [51.7, 55.5] of women reported barriers to healthcare utilisation. Women aged 25–29 years [aOR = 1.245; 95% CI: 1.01, 1.53] and 45–49 years [aOR = 1.377; 95% CI: 1.04, 1.82] had higher odds of facing barriers in healthcare services utilisation than those aged 15–19 years. The odds for experiencing barriers to healthcare utilisation were higher among women with two [aOR = 1.290; 95% CI: 1.06, 1.56], three [aOR = 1.478; 95% CI: 1.20, 1.82], and four or more children [aOR = 1.306; 95% CI: 1.05, 1.63], women of Ewe [aOR = 1.325; 95% CI: 1.07, 1.63], or Mole Dagbani ethnicity [aOR = 1.512; 95% CI: 1.22, 1.87] compared to those with no children and Akan women respectively. Lower odds were observed among women with higher education [aOR = 0.642; 95% CI: 0.49, 0.84], married [aOR = 0.555; 95% CI: 0.47, 0.66] or cohabiting women [aOR = 0.646; 95% CI: 0.55, 0.76], Muslims [aOR = 0.770; 95% CI: 0.64, 0.92], who watched Television [aOR = 0.776; 95% CI: 0.68, 0.88], and internet users [aOR = 0.765; 95% CI: 0.67, 0.87]. Those in the poorer [aOR = 0.666; 95% CI: 0.54, 0.82], middle [aOR = 0.453; 95% CI: 0.36, 0.58], richer [aOR = 0.368; 95% CI: 0.28, 0.48] and richest [aOR = 0.247; 95% CI: 0.18, 0.34] wealth quintile were less likely to experience barriers to healthcare services utilisation compared to the poorest. Regionally, women in Volta [aOR = 0.478; 95% CI: 0.33, 0.68], Bono [aOR = 0.488; 95% CI: 0.32, 0.76], and Upper East [aOR = 0.382; 95% CI: 0.21, 0.71] regions had lower odds of experiencing barriers to healthcare utilisation than those living in the Western region.ConclusionA higher proportion of women in Ghana experience barriers to healthcare utilisation. Older age, higher parity, higher educational attainment or level, access to media, religion, ethnicity, wealth index, marital status, and geographical region were factors identified to be associated with barriers to healthcare utilisation in Ghana. It is recommended that policymakers prioritise interventions aimed at addressing regional disparities in healthcare infrastructure, improving geographic accessibility to healthcare services, and tackling socioeconomic, cultural, and social determinants of health. Efforts should focus on strengthening community-based healthcare initiatives, strengthening health insurance coverage, and promoting health education and literacy programs. These interventions can enhance health outcomes and promote health equity nationwide.

Illustrating the Application of Brief Integrated Behavioral Health Prevention Visits

Objectives: This case study explores the application of a brief Integrated Behavioral Health-Prevention (IBH-P) model in a pediatric primary care setting that provides care to families experiencing complex psychosocial stressors. The model focuses on promoting social–emotional health and well-being while addressing structural and systemic inequities that hinder access to mental health care for families living in poverty and underresourced communities. The IBH-P visits use a universal, standardized approach, emphasizing trauma-informed care and recognizing the impact of caregiver well-being on the child. Method: This case study demonstrates the feasibility and impact of the IBH-P model through a case example of a Black family living below the federal poverty line. Results: The case study illustrates results previously documented in the literature regarding the impact of this IBH-P model. These include adherence to well child visits (WCVs), achieving developmental milestones on target, enhanced family distress tolerance and socioemotional well-being, reduced unnecessary emergency department visits, and sustained progress despite psychosocial risk factors. Conclusions: This case example highlights how IBH-P effectively supports families facing multiple challenges and promotes health equity for underresourced populations. It underscores the importance of culturally responsive care, standardization, and flexibility in building scalable and sustainable IBH programs.

Role and competency model for coordination tasks in municipal health promotion: findings from an integrative review

BackgroundIntegrated municipal health promotion is becoming increasingly important in promoting health equity. Successful implementation of integrated municipal health promotion processes requires a central coordinator. Therefore, this study investigates which competencies are necessary to successfully manage the extensive coordination tasks. The aim is to present the necessary roles and competencies in a way that can be applied in practice.MethodsAn integrative review was conducted. As a first step, a systematic search was carried out in the databases LIVIVO, Web of Science and via the EBSCOhost platform (including APA PsycInfo, ERIC, MEDLINE, CINAHL, APA PsycArticles, SocINDEX) using various inclusion and exclusion criteria (e.g. English and German language). The steps of systematic data extraction, data evaluation and data analysis were subsequently carried out. In accordance with the integrative review method, the data were then iteratively compared and synthesised, followed by the final step of presentation and integration in the form of a new model.ResultsAccording to the pre-defined inclusion and exclusion criteria, 12 hits were included. The results identified were combined into a concept for a role and competency model. Central competencies for the coordination of municipal health promotion are e.g., public health expertise, interprofessional competencies as well as coordination, communication, and management competencies.ConclusionsThe role and competency model presents the roles and competencies needed to coordinate integrated municipal health promotion processes and emphasises the need to work intersectorally. The model provides a guide for practical application and can contribute to the selection of qualified staff, professionalisation, training and curriculum development. It can make a quality-assured contribution to the structural development of integrated health promotion at local level. Further research is needed to validate the model in practice.Trial registrationThis integrative review was not registered beforehand.

The future of general practitioner care in Lower Saxony, Germany: an analysis of actual vs target states using a GIS-based floating catchment area method.

Ensuring universal and equitable accessibility to healthcare services is crucial for fostering equal living conditions aligned with global and national objectives. This study examines disparities in accessing General Practitioner (GP) care within Lower Saxony and Bremen, Germany, using the two-step floating catchment area method for spatial analysis at street section level, incorporating various transportation modes. Findings are compared with needs-related planning guidelines to uncover spatial disparities and deviations between prescribed guidelines (target state) and empirical findings (actual state). The analysis reveals significant discrepancies, with over 50% of the population inadequately supplied due to accessibility or capacity issues, particularly in rural and some urban areas, challenging assumptions of sufficient urban healthcare provision. This is the first detailed analysis of primary care provision at this granular level in Lower Saxony, exposing substantial gaps between current GP care and planning targets. Fine-grained spatial analysis proves essential for revealing healthcare accessibility inequities and offers a roadmap for targeted policy interventions. Despite limitations, such as not fully capturing real-world dynamics or patient preferences, the study provides valuable insights into enhancing geographically equitable GP care. It contributes to the discourse on achieving equal living conditions through equitable healthcare accessibility, advocating a more refined, localised approach to healthcare planning, emphasizing the importance of detailed spatial analysis for informed decision-making and promoting health equity.