Correlating Access to Primary Medical Care and Veterinary Care Providers: A Novel Application of Spatial Gravity Modelling

SIMPLE SUMMARY: Access to care is a challenge for both human medicine and animal medicine. The One Health paradigm recognizes that human, animal, and environmental health are interconnected. Focusing on the human and animal health aspects of this, this research evaluated whether there was a correlation between lack of access to primary care physicians and veterinary medical staff in a four-county study area in Alabama, USA. The research advanced the novel application of a spatial gravity model to take into account the impact of distance from provider on supply and demand for services. The research found that areas that had low access to primary care physicians also had low access to veterinary care. The implications for this work include suggestions for increased collaboration to resolve access challenges for both humans and animals and also details possible advancements of this type of modelling applied in a One Health perspective. ABSTRACT: Increasingly, health professionals are recognizing the need for a more holistic, or One Health, approach to wellness. Companion animals share the lives and homes of many Americans, and yet little research exists on the intersection of disparities of access to veterinary care and access to human health care. This research aims to fill that gap by exploring the use of a spatial model that identifies the relationship of supply and demand while also considering reductions as a function of travel time to a care facility. Four counties in Alabama were analyzed at the census tract level to determine the supply of primary care physicians and veterinary care providers. This research provides a unique application of the Enhanced Two-Step Floating Catchment Area model by independently examining access to each type of care and then comparing both access supply values at the census level. Results indicated a statistically significant positive relationship between access to both types of care, implying areas with lower access to primary care have concomitantly low access to veterinary care. Implications for practice include the introduction of this methodological approach, identification of future parameter specification research to improve the approach, and identification of an area of significant concern in the One Health framework. Further, the results can inform solution strategies such as offering integrated care interventions for both humans and their companion animal household members with direct use for policymakers aimed at increasing equitable access to health care across the One Health spectrum.