Healthcare at Arm's Length: Exploring the association of distance and household wealth index in Odisha, India

Introduction: Location or distance from healthcare facilities affects the use of health facilities of households. Use of health facilities also have an impact on the socioeconomic conditions. Distance from healthcare facilities significantly affects catastrophic health expenditures. This study aimed to determine the association of physical distance to healthcare facilities with the economic deprivation of households. Objective: This study aims to analyze the distance of healthcare facilities from households in different wealth index categories of Odisha. The study argues that the household wealth index is associated with the distance to healthcare facilities. Methodology: This study is based on six purposively selected districts in Odisha: Rayagada, Kalahandi, Angul, Keonjhar, Khordha, and Kendrapara. A cross-sectional household survey was conducted to collect the data. A total of 902 household data points were collected. Data analysis was carried out in SPSS version 25. Results: A difference is observed among households that need to travel more than one hour to reach a private doctor or private hospital: 42.6% of poor households face this challenge, whereas only 25% of wealthy households do. Among those who cannot reach a public hospital in less than an hour, a larger proportion are from poor households (62.6%). The poor and wealthy segments of the population have nearly equal access to NGO-run healthcare facilities in terms of proximity. We observe that poor households are less likely than wealthy households to reach private pharmacists in less than an hour and are more likely to require over an hour to reach them. Conclusion: Ensuring healthcare facilities is the minimum requirement within one hour of reach for every household in India. Underreporting of illnesses and diseases is one of the major factors of high mortality in the population. Physical accessibility to healthcare facilities can reduce the mortality burden on the population.