Background <p>Healthcare equity is crucial for providing public medical services. Enabling equitable and timely access to healthcare services is of critical importance to all populations, particularly for the aging population in a developing economy during a large-scale urbanization process.</p> Methods <p>Surveys, interviews, and discussions have been carried out to identify indicators for healthcare equity. An improved two-step floating catchment area (i2SFCA) method is proposed to evaluate accessibility to health facilities. A mixed integer programming model is used to improve equity. A case study is introduced to illustrate the applicability of the method.</p> Results <p>First, an indicator index system to measure equity is proposed. Then, the 2SFCA method is improved to consider different needs and preferences of the aging population for acute and chronic diseases. An optimization model using mixed integer programming is proposed to allocate regional medical resources to improve equity. A case study in a central district of a metropolitan area is carried out to analyze and improve healthcare equity.</p> Conclusion <p>This paper introduces an analysis and optimization framework to study healthcare equity from the perspective of medical resource allocation in an aging society. It provides health service management and urban planners with a quantitative tool to design the distribution of medical resources with the consideration of healthcare equity for the aging population.</p>