Measuring Multimodal Accessibility to Urban Services for the Elderly. An Application at Primary Health Services in the City of Naples

In Europe, the share of people aged 65 years and over is expected to increase exponentially, and for the first time in human history, in 2050, the number of older people will be greater than the number of children under 15 years old. At the same time, aging is associated to an increased vulnerability and dependence on medical care services. An ageing population poses various challenges to a society and improvements in the medical and transportation systems are needed to maintain and to improve the quality of life of the elderly population. From the perspective of social equity, everyone should have the opportunity to access such services equally, but because of economic and geographical issues, it is a challenge to achieve such level of equity. The aim of this study is to fill the gap between scientific and real practices through an accessibility measure able to evaluate urban accessibility to primary healthcare services and to support decision- makers to better allocate resources, in local welfare policies restructuring. The accessibility measure was designed considering both the land-use and the transportation components, taking into account the local healthcare supply system and a multimodal transportation network. The methodology was applied for the city of Naples, considering Local Health Agency (ASL) healthcare services to elderly population. The supply consists of 17 buildings used by nearly 200,000 of old people. The outputs show that entire neighbourhoods’ elderly population suffer from a very poor accessibility to primary health services, especially in the city suburbs, and that the methodology could be effective in urban palling strategies to achieve a high quality of life for elderly people.