Spatial inequity in distribution of COVID-19 vaccination services in Aotearoa
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Abstract
Aim
This research examines the spatial equity, and associated health equity implications, of the geographic distribution of Covid-19 vaccination services in Aotearoa New Zealand.
Method
We mapped the distribution of Aotearoa’s population and used the enhanced-two-step-floating-catchment-method (E2SFCA) to estimate spatial access to vaccination services, taking into account service supply, population demand, and distance between populations and services. We used the Gini coefficient and both global and local measures of spatial autocorrelation to assess the spatial equity of vaccination services across Aotearoa. Additional statistics included an analysis of spatial accessibility for priority populations, including Māori (Indigenous people of Aotearoa), Pacific, over 65-year-olds, and people living in areas of high socioeconomic deprivation. We also examined vaccination service access according to rurality, and by District Health Board region.
Results
Spatially accessibility to vaccination services varies across Aotearoa, and appears to be better in major cities than rural regions. A Gini coefficient of 0.426 confirms that spatial accessibility scores are not shared equally across the vaccine-eligible population. Furthermore, priority populations including Māori, older people, and residents of areas with socioeconomic constraint have, on average, statistically significantly lower spatial access to vaccination services. This is also true for people living in rural areas. Spatial access to vaccination services, also varies significantly by District Health Board (DHB) region as does equality of access, and the proportion of DHB priority population groups living in areas with poor access to vaccination services. A strong and significant positive correlation was identified between average spatial accessibility and the Māori vaccination rate ratio of DHBs.
Conclusion
Covid-19 vaccination services in Aotearoa are not equitably distributed. Priority populations, with the most pressing need to receive Covid-19 vaccinations, have the worst access to vaccination services.
Article activity feed
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SciScore for 10.1101/2021.08.26.21262647: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 51 To examine the equality of spatial access to COVID-19 vaccination services, the population weighted Gini coefficient was calculated in R 52 using the ACID package. ACIDsuggested: (ACID, RRID:SCR_010470)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are some limitations to this work. Although information on vaccination services listed on the Health Point website …
SciScore for 10.1101/2021.08.26.21262647: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 51 To examine the equality of spatial access to COVID-19 vaccination services, the population weighted Gini coefficient was calculated in R 52 using the ACID package. ACIDsuggested: (ACID, RRID:SCR_010470)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are some limitations to this work. Although information on vaccination services listed on the Health Point website is likely to be accurate and reflective of the actual services available on 18th August 2021, it will not reflect all of the additional clinics that have been set up since that date in response to the Covid-19 delta variant outbreak which began on 17th August 2021. Our analysis does not include any vaccination services that are not listed on the Health Point website. While this limitation is beyond the control and scope of this paper, it does highlight the importance of strong public health intelligence, including the collection and maintenance of information on service delivery. Furthermore, it is important to note that our analysis has not included any information on the capacity of vaccination services, the availability of appointments, or the different service models that may be used by vaccination services. Likewise, it does not assess the wider domains of accessibility (such as the acceptability or services) beyond spatial access. Despite these limitations, this analysis indicates that, as has been predicted previously,7 spatial access to vaccination services across Aotearoa is inequitable. It shows that, in particular, Māori, over 65-year olds, people living in areas of high socioeconomic constraint, and rural residents have worse access to vaccination services. Given the higher burden of disease, and likelihood of more severe outcomes of Covid-19 in...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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