Assessing equity of access: a needs index for digital health stations in Queensland, Australia

Digital health stations provide free health checks for users in public settings such as retail environments, enabling self-service measurement of cardiometabolic health risk factors including blood pressure, body mass index (BMI) and Type 2 diabetes risk. This study aimed to develop a method of quantifying need for health stations, and to measure equity of access to stations across geographical areas in Queensland, Australia. Using Bradshaw's Taxonomy of Need, variables representing multiple dimensions of need were identified and combined using Principal Components Analysis to derive a Health Station Needs Index. This index was used to assess equity of access to stations in Queensland, using equity ratios, logistic regression, Gini Coefficients and concentration curves. The Gini coefficients for number of health stations (0.599), per capita health stations (0.695), distance to the closest health station (0.788), and number of health checks per capita (0.395) across needs index deciles highlight inequitable distribution of health stations in Queensland. When considering distance to the closest health station, inequity disadvantaging higher need regions was supported by a high equity ratio (20.82), a positive significant relationship between need and distance (β = 0.529) and a concentration index with a high negative value (-0.690). By adopting a systematic data-driven approach, this research reveals a clear gap in geographic access based on distance to health stations in areas with the greatest health need. It underscores the importance of considering need as a major criterion in future planning for health station locations and provides a measure of need for this purpose.