From spatial accessibility to perceived healthcare opportunity: Diagnosing mismatches for affordable housing residents in Shenzhen

Rapid urbanization may widen the gap between spatially reachable healthcare resources and residents' perceived healthcare opportunity, raising equity concerns for affordable housing residents. Using Shenzhen, China, as an empirical case, this study develops an integrated framework for assessing healthcare accessibility and constraint gaps to diagnose mismatches between objective accessibility and residents’ perceived healthcare opportunities. Objective accessibility was measured using the Gaussian two-step floating catchment area method under public transport and private vehicle modes, while perceived healthcare opportunity was assessed through perceived constraint gaps covering transport access, healthcare service access, and equity-related constraints. The results reveal three key findings: (1) objective healthcare accessibility varied by transport mode and spatial location, with weaker access in some peripheral affordable housing communities; (2) perceived constraint gaps differed across dimensions and resident groups, with stronger constraints among low-income residents and residents without private vehicles; and (3) objective accessibility did not consistently align with perceived healthcare opportunity, with transport mode mismatches and non-time constraints revealing limitations that may be overlooked by spatial measures alone. This study extends healthcare accessibility assessment by diagnosing these mismatches and provides empirical evidence for improving healthcare and transport equity for affordable housing residents.