تحلیل نابرابری های فضایی توزیع خدمات درمانی از منظر عدالت فضایی مطالعه موردی: محلات شهر اصفهان (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
با توجه به رشد بیماری ها، سیر صعودی آلودگی ها و ناهنجاری های مرتبط با شهرنشینی، خدمات درمانی ازجمله مهم ترین خدماتی است که باید متناسب با نیاز و جمعیت شهرها موردتوجه مدیران و برنامه ریزان شهری واقع شود. بر این اساس این پژوهش به سنجش نابرابری فضایی در توزیع خدمات درمانی در محلات شهر اصفهان می پردازد. هدف پژوهش، کاربردی و ازنظر ماهیت و روش توصیفی- تحلیلی است. از روش کتابخانه ای برای گردآوری داده ها و اطلاعات لازم بهره گرفته شد. توابع تحلیل نزدیک ترین همسایگی، شاخص موران محلی، موران جهانی و تحلیل لکه های داغ برای تجزیه وتحلیل چگونگی الگوی توزیع فضایی خدمات درمانی، روش عضویت فازی برای بررسی مطلوبیت شعاع عملکردی این خدمات و شاخص دومتغیره موران در محیط نرم افزاری Geo Da، جهت تحلیل خودهمبستگی فضایی متغیر جمعیت در ارتباط با پراکنش و مساحت خدمات درمانی در سطح محلات شهر اصفهان به کار گرفته شدند. یافته های پژوهش نشان می دهند الگوی پراکنش خدمات درمانی به صورت خوشه ای است. همچنین کمبود شدید خدمات درمانی در محلات پیرامون شهر را نشان می دهد. ارزیابی تأثیرگذاری الگوی توزیع فضایی این خدمات بر میزان مطلوبیت شعاع عملکردی بیانگر مطلوبیت شعاع عملکردی مناطق مرکزی و نامطلوبی مناطق پیرامون شهری می باشد. سنجش ارتباط بین توزیع خدمات درمانی و میزان جمعیت محلات نیز ارتباط بسیار ضعیف این دو متغیر را تأیید می کند و عدم توجه به عامل جمعیت و نیاز شهروندان در راستای توزیع خدمات درمانی را نشان می دهد. درنتیجه نابرابری فضایی شدیدی در توزیع خدمات درمانی در سطح مناطق و محلات شهر اصفهان برقرار استAnalysis of the Inequality of Spatial Distribution of Medical Services by the approach of Spatial Justice the case study of Isfahan neighbourhoods
Considering the growth of diseases, the rising course of pollution and anomalies related to urbanization, medical services are among the most important services that managers and urban planners should consider according to the needs and population of cities. Based on this, this research measures the spatial inequality in the distribution of medical services in the neighbourhoods of Isfahan City. The purpose of the research is applied and descriptive-analytical in terms of its nature and method. A library method was used to collect the necessary data and information. Nearest neighbourhood analysis functions, local Moran's index, global Moran's index and hot spot analysis to analyze the spatial distribution pattern of medical services, fuzzy membership method to check the usefulness of the functional radius of these services and Moran's bivariate index in the Geo Da software environment, to analyze the spatial autocorrelation of the population variable In connection with the distribution and area of medical services at the level of neighbourhoods of Isfahan city, they were used. The findings of the research show that the distribution pattern of medical services is clustered. It also shows the severe lack of medical services in the neighbourhoods around the city. The evaluation of the impact of the spatial distribution pattern of these services on the desirability of the functional radius indicates the desirability of the operating radius of the central areas and the unfavourable of the peri-urban areas. Measuring the relationship between the distribution of medical services and the population size of the neighbourhoods also confirms the very weak relationship between these two variables. It shows the lack of attention to the population factor and the needs of citizens in terms of the distribution of medical services. As a result, there is a severe spatial inequality in the distribution of medical services at the level of the regions and neighbourhoods of Isfahan City
Extended
Introduction
Urban services are a tool in management of urban development and a major factor in the continuity of urban life without which lives of citizens lose activeness and reduction in its efficiency causes reduced welfare of citizens. In fact, following the extension of cities and the growth of urban population, demand to use Urban services also increases. Considering the rising trend of pollution, the growth of diseases and anomalies related to urbanization, medical services is one of the most important services that should be considered in proportion to the needs and population of cities. Accordingly, this study measures spatial inequality in the distribution of medical services in the neighborhoods of Isfahan. Isfahan is one of the cities located in the arid region of Iran and due to many constraints, problems with transportation network, poor urban environment, lack of spaces and cultural sites and so on. Finds more and provides for the creation of inequality and unhealthy competition for access to city-wide amenities. The purpose of this paper is to evaluate the spatial pattern of medical in Isfahan city, to obtain the effect of spatial distribution pattern of medical on utility radius of this land use and to measure the relationship between spatial distribution of medical and the amount of population corresponding to their location. Isfahan is a city.
Methodology
This study is applied in terms of purpose and descriptive-analytical in nature and method. To analyze the results, the basic graphical methods used in Arc GIS and Geo Da software are used. The method of data collection was library and after gathering basic statistics and information such as maps related to Isfahan Master Plan studies, location of medical services was determined and extracted. Then, using nearest-neighbor function, local mooring index, global mooring index and hot spots analysis of spatial distribution pattern of medical services were determined and their functional radius desirability was evaluated by fuzzy membership method. Finally, by overlapping the location information of urban services and urban neighborhoods of Isfahan, the medical services available in each specific neighborhood and considering the population of each neighborhood based on the data extracted from the results of the census results of Isfahan urban blocks in 2016, there is a significant relationship between population number variables. Isfahan was characterized by the spatial distribution of these services and the existence of spatial autocorrelation among the mentioned variables.
Results and Discussion
Nearest neighbor tool showed that medical services are clustered in Isfahan city. But according to the Moran Global index calculations, medical distributions, with 99% confidence, are distributed random across neighborhoods. By calculating the local Moran for Isfahan's neighborhoods, it was determined that a neighborhood from region 4, a neighborhood from region 5, and a neighborhood from region 10 at the High-Low clustering level had formed a single clumsy formation. These neighborhoods have a large number of health services, but with neighbors with less records, they have not been able to form a cluster. Also, a High-High neighborhood in region 6 has formed an unhealthy formation. This means that the neighborhood and its neighboring neighborhoods have the highest per capita therapeutic use. According to hot spot analysis maps, neighborhoods and central areas, especially areas 3, 8, 10 and 14, form hot spots due to the high establishment of medical services. Moving to the suburbs of the city, the amount of Z-Score is reduced and they move towards the formation of cold spots. This situation is well evident in the northern, western and southern parts of the city, especially in region 7, and shows the severe shortage of medical services in these neighborhoods.
Conclusion
The results indicate that the spatial distribution of medical services in the neighborhoods of Isfahan is inappropriate, so that the desirability of access to this use in the central areas is high and citizens in the surrounding neighborhoods and suburbs are denied access. Therefore, in order to eliminate this major space gap, it is necessary to consider programs and policies in order to establish spatial justice in the neighborhoods of Isfahan, and finally social justice will cover the city. For this purpose, in order to achieve justice in the field of distribution of medical facilities and services and to eliminate the gap in health care in Isfahan, it is necessary to pay more attention to less privileged areas around the city and these neighborhoods should be given priority in infrastructure investments. More attention should be paid to the demographic threshold of different urban areas and the optimal provision of health care services according to the population capacity and needs of these areas. There should also be a favorable interaction between the various bodies that lead to unity of procedure in the development of justice, welfare, comfort and public health.
Funding
There is no funding support.
Authors’ Contribution
All of the authors approved thecontent of the manuscript and agreed on all aspects of the work.
Conflict of Interest
Authors declared no conflict of interest.
Acknowledgments
We are grateful to all the scientific consultants of this paper.
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