Uneven Paths to Health: A Spatial Analysis of Sidewalk Conditions and Healthcare Access for Older Adults

As urban populations age, the built environment becomes a vital determinant of health equity. This research evaluates the sidewalk infrastructure, surrounding the Health Center in Aigaleo, Greece, in order to quantify its impact on healthcare accessibility for older adults. Using a GIS-based approach to simulate realistic navigation, a routing algorithm prioritized the "easiest" path over the shortest distance by transforming accessibility scores into traversal costs. The results revealed a significant disadvantage in healthcare access, with routes to the Health Center scoring lower than the average accessibility of the greater study area. In addition, the negative correlation (r = -0.20, p < 0.001) confirms the pattern of environmental injustice, where neighborhoods with the highest older adult density systematically face the poorest infrastructure. Eventually, Moran’s I of 0.912 identifies the "Accessibility Deserts" which are comprised of a 92.5% absence of crosswalks and an 81.7% rate of obstructions. This study outlines that those who depend most on the sidewalk network, are disproportionately affected by inadequate urban planning conditions. By underscoring the necessity to remediate these low-accessibility clusters, public health is improved, ensuring equitable healthcare access and supporting healthy aging.