The impact of transportation equity on healthcare accessibility for children with asthma

• The two-step floating catchment area approach quantifies spatial accessibility. • Private vehicles are the most equitable mode for healthcare access. • Public transit and taxis fail to meet emergency healthcare visit travel needs. • Taxis provide an equitable option for non-emergency healthcare visits at a high fare. • The observed disparities in accessibility inform targeted policy measures. Equitable access to healthcare facilities is essential to quality of life. However, many vulnerable communities encounter barriers because transportation systems are not designed to serve all residents equally. These disparities are particularly significant for childhood asthma, a public health concern where timely care is essential to prevent adverse outcomes. This study addresses the gaps in understanding how various transportation modes, including public transit, private vehicles, and taxis, influence healthcare accessibility for children with asthma. Using data from 18,393 hospital visits in Calgary, Canada (2010–2021), we evaluate spatiotemporal accessibility across three travel modes, considering emergency and non-emergency healthcare visit scenarios with varying travel cost thresholds through a two-step floating catchment area (2SFCA) method. Horizontal equity is quantified using the Gini coefficient, while vertical equity incorporates socioeconomic factors and asthma prevalence. Our findings reveal that personal vehicles provide the highest and most reliable accessibility, especially during emergencies, whereas public transit frequently fails to meet emergency accessibility demands, particularly at night. Taxis tend to be unaffordable for low-income users but offer comparable accessibility for higher-income travelers in non-emergency contexts. The vertical equity analysis identifies areas characterized by high socioeconomic vulnerability, elevated asthma prevalence, and limited access to healthcare, highlighting zones that warrant targeted interventions to enhance equity in healthcare accessibility.