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Amanda Maze

Analyzing Geographic Barriers to Mental Health Care Within the City of Toronto © 2004

The purpose of this paper is to investigate whether a demonstrated relationship between socioeconomic status and psychiatry visits can be attributed to decreased accessibility of lower socioeconomic neighbourhoods to this service. Research to date has highlighted that individuals of high socioeconomic status in the city of Toronto are more likely to access psychiatric care at least once and are also more likely to make return visits. This study adopts a network analysis approach to mental health care accessibility. Constructed for the investigation were two unique road networks- one pertaining to road speeds and turn impedances related to personal vehicle travel and the other involving time impedances for travel using public transportation. The analysis incorporates a GIS framework to assess whether geography is a barrier to care. Procedures include: i) network analyses of accessibility along driving and transit/pedestrian networks; and, ii) local and global measures of spatial auto correlation for utilization rates, psychiatrist location data, and census variables. The key findings of the study demonstrate that within Toronto geography is only a minor barrier to mental health care accessibility, however, a number of peripheral areas can be identified where the level of accessibility raises concerns with regard to health care equity. Finally, further areas of research are forwarded.

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