Threshold effects between spatial access to medical resources and life expectancy: a 19-year longitudinal study in...

While the positive link between medical resource allocation and life expectancy has been widely explored, the threshold effects of spatial access to medical resources from a longitudinal perspective remain underexplored. Studying these threshold effects is important to improve urban medical resource allocation and to protect human health. We used official records from 41 public hospitals and applied the Enhanced Two-Step Floating Catchment Area (E2SFCA) method to measure the spatial access to medical professionals and medical services in 179 community-level planning units (STPUGs). We then used 727,802 valid mortality records in Hong Kong from 2000 to 2018 to test the link between medical resource accessibility and years of life lost (YLL). Our analysis revealed three key findings: (1) Better access to medical professionals and services is associated with higher life expectancy, and medical services have a stronger effect than medical professionals; (2) The relationships between spatial access to medical resources and life expectancy show non-linear patterns and threshold effects; (3) These relationships vary across different income groups. These results provide empirical evidence to improve medical resource allocation and to build equitable medical systems and sustainable social development.