Evaluating and Comparing Methods for Measuring Spatial Access to Mammography Centers in Appalachia (Re-Revised)

Area of Science:

• Geographic Information Systems (GIS) in Public Health
• Healthcare Access and Disparities Research
• Spatial Epidemiology

Background:

• Mammography is crucial for early breast cancer detection.
• Access to mammography services can be unevenly distributed.
• Appalachian regions often face unique healthcare access challenges.

Purpose of the Study:

• To evaluate spatial access to mammography centers in Appalachia.
• To compare traditional access measures with the two-step floating catchment area (2SFCA) method.
• To identify disparities in mammography access within Appalachian areas.

Main Methods:

• Compared county mammography center ratios to women aged 45+.
• Assessed driving time to the nearest mammography facility.
• Applied various 2SFCA approaches across Pennsylvania, Ohio, Kentucky, and North Carolina.

Main Results:

• Traditional travel time measures favored urban accessibility.
• 2SFCA results varied based on chosen parameters.
• Appalachian areas exhibited longer travel times to mammography centers.
• Appalachian regions in Ohio and North Carolina showed poorer 2SFCA scores than non-Appalachian areas.

Conclusions:

• The spatial access ratio (SPAR) method, a relative 2SFCA approach, is recommended.
• SPAR helps minimize discrepancies between different 2SFCA methodologies.
• This approach offers a more nuanced understanding of spatial access to mammography.