Abstract
Introduction In the United States, health care has long been viewed as a ‘right,’ and residents of the state of Ohio
are no exception. The Ohio Department of Health ensures that this right exists for all residents of Ohio. Socio-spatial
characteristics, however, can have an impact on access to health care, particularly among vulnerable groups. This
article seeks to measure the spatial accessibility to healthcare services by public transport in the six largest cities of
Ohio based on population and to compare the accessibility of healthcare to vulnerable demographic groups. To the
authors’ knowledge, this is the first study to analyze the accessibility and equity of hospitals by public transit across
different cities in Ohio, allowing the identification of common patterns, difficulties, and knowledge gaps.
Methodology Using a two-step floating catchment area technique, the spatial accessibility to general medical and
surgical hospitals through public transportation was estimated, considering both service-to-population ratios and
travel time to these health services. The average accessibility of all census tracts and the average accessibility of the
20% of most susceptible census tracts were determined for each city. Using Spearman’s rank correlation coefficient
between accessibility and vulnerability, an indicator was then devised to evaluate vertical equity.
Findings Within cities (except Cleveland), people of vulnerable census tracts have less access to hospitals via public
transportation. These cities (Columbus, Cincinnati, Toledo, Akron, and Dayton) fail in terms of vertical equity and
average accessibility. According to this, vulnerable census tracts in these cities have the lowest accessibility levels.
Conclusion This study emphasizes the issues connected with the suburbanization of poverty in Ohio’s large cities
and the need to provide adequate public transportation to reach hospitals on the periphery. In addition, this study
shed light on the need for additional empirical research to inform the implementation of guidelines for healthcare
accessibility in Ohio. Researchers, planners, and policymakers who want to make healthcare more accessible for
everyone should take note of the findings in this study.