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<p>This paper examines spatial access to hospitals for older adults in Baltimore, Maryland, with a particular focus on the demographic shifts in the population from 1990 to 2020, as the city experiences a decline in overall population but an increase in residents over 65. The study shows the changes in the spatial distribution of older adult populations in Baltimore over 30&#xa0;years (1990–2020), and examines the influence these demographic shifts had on spatial access to health services. Two data sets are used in this study. First, the Decennial Census’ of 1990, 2000, 2010, and 2020 block group data for the City of Baltimore. Second, the state of Maryland’s hospital location data. This study uses an Enhanced Two-Step Floating Catchment Area (E2SFCA) to calculate accessibility to hospitals and measure change in access over time and employs an aging-in-place model to compare 1990 trends to 2020 population. Findings from the spatial (mis)match and aging-in-place analysis offer insights on designing more agefriendly cities and deepen conversations about the (mis)alignment of historic urban infrastructure and the changing landscape of older adults aging in their homes, suggesting opportunities to improve the realized utilization of health services for older adult populations.</p>

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Evaluating spatial access to hospitals for aging populations in legacy cities: a case study of Baltimore, Maryland

  • 期刊论文

  • 发表日期：

    2025年6月5日

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  • Leiha Edmonds,
  • Paul Delamater

摘要

This paper examines spatial access to hospitals for older adults in Baltimore, Maryland, with a particular focus on the demographic shifts in the population from 1990 to 2020, as the city experiences a decline in overall population but an increase in residents over 65. The study shows the changes in the spatial distribution of older adult populations in Baltimore over 30 years (1990–2020), and examines the influence these demographic shifts had on spatial access to health services. Two data sets are used in this study. First, the Decennial Census’ of 1990, 2000, 2010, and 2020 block group data for the City of Baltimore. Second, the state of Maryland’s hospital location data. This study uses an Enhanced Two-Step Floating Catchment Area (E2SFCA) to calculate accessibility to hospitals and measure change in access over time and employs an aging-in-place model to compare 1990 trends to 2020 population. Findings from the spatial (mis)match and aging-in-place analysis offer insights on designing more agefriendly cities and deepen conversations about the (mis)alignment of historic urban infrastructure and the changing landscape of older adults aging in their homes, suggesting opportunities to improve the realized utilization of health services for older adult populations.