Uneven Paths to Health: A Spatial Analysis of Sidewalk Conditions and Healthcare Access for Older Adults

As urban populations age, the built environment becomes a vital determinant of health equity. This research evaluates the sidewalk infrastructure, surrounding the Health Center in Egaleo, Greece, in order to quantify its impact on healthcare accessibility for older adults. Using a GIS-based approach to simulate realistic navigation, a routing algorithm prioritized the “easiest” path over the shortest distance by transforming accessibility scores into traversal costs. The results revealed a significant disadvantage in healthcare access, with routes to the Health Center scoring lower than the average accessibility of the greater study area. In addition, the negative correlation (r = −0.20, p < 0.001) confirms the pattern of accessibility disparity, where neighborhoods with the highest older adult density consistently face the poorest infrastructure. Eventually, Global Moran’s I of 0.912 confirms strong spatial autocorrelation, Local Indicators of Spatial Association (LISA) identifies “Accessibility Deserts” which comprise a 92.5% absence of crosswalks and an 81.7% rate of obstructions. This study outlines that those who depend most on the sidewalk network are disproportionately affected by inadequate urban planning conditions. By underscoring the necessity to remediate these low-accessibility clusters, public health is improved, ensuring equitable healthcare access and supporting healthy aging.