Study on spatial synergy and identification of dual-disadvantage zones of healthcare facility equity and environmental health elements in Zhengzhou city

In the context of rapid urbanization, urban residents face challenges from both declining environmental quality and unequal healthcare resource distribution. This study examines Zhengzhou’s core urban area to explore the spatial relationship between key ecosystem services (urban cooling and air purification) and access to the highest tier of medical facilities (Grade A Class III hospitals), which are critical for handling severe and complex health conditions. Utilizing a robust framework combining InVEST model, the Gravity-based Two-Step Floating Catchment Area (G2SFCA) method, and bivariate spatial autocorrelation analysis, this research aims to unveil their spatial synergistic patterns and identify dual-disadvantage zones characterized by deficiencies in both environmental health elements and critical healthcare service supply. The findings reveal that urban ecosystem regulating services exhibit a gradient pattern, increasing from the urban core outwards, with the weakest provision within the Third Ring Road and the strongest beyond the Fourth Ring Road. Accessibility to Grade A Class III hospitals demonstrates a spatial pattern characterized by high levels within the Third Ring Road, weaker accessibility beyond this ring in the western, southern, and northern peripheries, and strong accessibility in the eastern areas. Equity in healthcare resource distribution is relatively high in traditional core districts such as Jinshui, while being severely deficient in emerging areas like Huiji and zones along the Third Ring Road. Through bivariate spatial autocorrelation and spatial matching analyses, the study identifies dual-disadvantage zones predominantly concentrated near the Third Ring Roads within Zhongyuan and Erqi. These zones concurrently face challenges of poor environmental quality and a scarcity of high-quality healthcare resources, thereby posing a dual threat to residents’ health and well-being. These findings hold significant theoretical and practical implications for enhancing healthcare resource allocation, promoting environmental justice, and improving environmental health management.