Is accessibility in the eye of the beholder? Social inequalities in spatial accessibility to health-related resources in Montréal, Canada

Julie Vallée (1) , Martine Shareck (2) , Guillaume Le Roux (3) , Yan Kestens (4) , Katherine Frohlich (4)

1 GC (UMR_8504) - Géographie-cités
2 Dalla Lana School of Public Health
3 INED - Institut national d'études démographiques
4 Ecole de Santé Publique de l'Université de Montréal

Neighbourhood resources are often considered to be spatially accessible to people when they are located close to their place of residence, a perspective which overlooks individuals' unique lived experience of their neighbourhood and how they define it. Drawing on the relational approach to place and on Sen's capability approach, we explore spatial accessibility to health-related resources, and the social gradient therein, in light of people's place experiences. Using data from 1,101 young adults from Montreal (Canada) who participated in the Interdisciplinary Study of Inequalities in Smoking (ISIS), we compare the social gradients in the presence of health-related resources located (i) within uniform areas (defined as circular buffers and road-network buffers) around participants' place of residence; and (ii) within participants' self-defined neighbourhoods. Social inequalities in accessibility to a diversity of health-related resources (grocery stores, fruit and vegetable stores, eating and drinking places, recreational sports centres, civic, social, and fraternal organizations, bike paths, parks, social services, libraries, dental offices, physician offices) were more pronounced in self-defined neighbourhoods than in uniform buffer areas. Neglecting the variability in people's place experiences may distort the assessment of social inequalities in accessibility, and ultimately, of neighbourhood effects on health inequalities.

Mots clés: accessibility; perceived neighbourhood; place experiences; proximity; PARIS team; ACL; capability approach; social inequalities; relational approach

Domaines: Géographie; Démographie; Santé publique et épidémiologie; Sociologie

Julie Vallée, Martine Shareck, Guillaume Le Roux, Yan Kestens, Katherine Frohlich. Is accessibility in the eye of the beholder? Social inequalities in spatial accessibility to health-related resources in Montréal, Canada. Social Science & Medicine, 2020, 245, pp.112702. ⟨10.1016/j.socscimed.2019.112702⟩. ⟨hal-02389856⟩