Associating socioeconomic factors with access to public healthcare facilities using geographically weighted regression in the city of Tshwane, South Africa

Abstract

Access to healthcare is influenced by various socioeconomic factors such as income, population group, educational attainment and health insurance. This study used Geographically Weighted Regression (GWR) to investigate spatial variations in the association between socioeconomic factors and access to public healthcare facilities in the City of Tshwane, South Africa based on data from the Gauteng City-Region Observatory Quality of Life Survey (2020/2021). Socioeconomic predictors included population group, income, health insurance status and health satisfaction. The GWR model revealed that all socioeconomic factors combined explained the variation in access to healthcare facilities (R²=0.77). Deviance residuals, ranging from -2.67 to 1.83, demonstrated a good model fit, indicating the robustness of the GWR model in predicting access to healthcare facilities. Black African, low-income and uninsured populations had each a relatively strong association with access to healthcare facilities (R²=0.65). Additionally, spatial patterns revealed that socioeconomic relationships with access to health care facilities are not homogeneous, with significance of the relationships varying with space. This study highlights the need for a spatially nuanced approach to improving healthcare facilities access and emphasizes the need for targeted policy interventions that address local socio-environmental conditions.