Xiaoya Chen, Qin Ye, Jianghong Zhu
Taking the main urban area of Guangzhou as a case study, this research employs the Gaussian two-step floating catchment area (Ga2SFCA) method to evaluate the spatial accessibility of primary healthcare (PHC) facilities under four travel modes-walking, e-bike, driving, and transit. By integrating spatial analysis with socioeconomic characteristics, the study reveals the spatial patterns and disparities of accessibility. The results show significant differences in accessibility among socioeconomic groups, with e-bike travel substantially improving overall accessibility. By further constructing a Demand Index for Vulnerable Groups (DIVG) and performing cluster analysis, the study identifies a pronounced spatial mismatch between PHC supply and demand across different areas. Some peripheral sub-districts exhibit relatively high accessibility but limited service demand, whereas the core urban area experiences a decline in relative accessibility due to concentrated population and healthcare needs. Meanwhile, the dynamics of the urban housing market exacerbate spatial injustice, resulting in the coexistence of relative shortages in high-demand areas and surpluses in low-demand areas. The findings suggest that improving non-motorized transport systems and optimizing spatial layouts guided by the needs of vulnerable populations are crucial pathways toward achieving spatial justice within the "15-minute neighborhood" and enhancing health equity in Guangzhou.