{"doi":"10.1371/journal.pone.0330427","title":"Disparities in multi-modal spatial access to primary and specialty care in U.S. neighborhoods: A cross-sectional and temporal analysis of health services","abstract":"Spatial access to care describes the ability of populations to travel to healthcare providers. Existing spatial access to care studies frequently utilize metrics constructed using car-specific travel to providers, potentially underestimating access in populations using other travel modalities (i.e., walking/transit). We present a novel multi-travel modality spatial access to care composite measure, a corresponding temporally representative open-source data resource, and a stratified analysis of neighborhood rural/urban and socioeconomic disparities. We utilized quarterly 2016-2020 Centers for Medicare and Medicaid Services Doctors and Clinicians National Downloadable Files to compute temporally representative multi-modal spatial accessibility to 56 healthcare provider classifications in U.S. census tracts and block groups. We performed tract-level analyses stratified by 2010 Rural-Urban Commuting Area Codes and 2016 Area Deprivation Index for a subset of provider types. We found that 1) non-metropolitan areas have poorer multi-modal spatial access to primary (P < 0.001), specialty (P < 0.001), pulmonology (P < 0.001), nephrology (P < 0.001), and cancer care (P < 0.001) than metropolitan areas both cross-sectionally and over time and 2) multi-modal primary care access was substantially poorer than multi-modal specialty care access in 2016 and this trend did not improve over time. We also produced a data resource for many provider types and an interactive spatial access map for a subset of provider classifications. After stratifying, we found significant disparities in spatial access to primary care, specialty care, pulmonology, nephrology, and cancer care in non-metropolitan areas. Our multi-modal spatial access measure and corresponding data resource may be useful for population health and clinical studies, public health entities, community stakeholders, health systems, and policymakers.","journal":"PLoS ONE","year":2025,"id":524444,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.945,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":913266,"name":"Paul R. Gunsalus","orcid":"0000-0001-6976-9094","position":1,"is_corresponding":false},{"id":1397952,"name":"Madeleine Blazel","orcid":"0009-0006-6508-987X","position":2,"is_corresponding":false},{"id":1398473,"name":"Michael W. Kenyhercz","orcid":null,"position":3,"is_corresponding":false},{"id":406915,"name":"Jarrod E. Dalton","orcid":"0000-0001-8336-1212","position":4,"is_corresponding":false},{"id":920912,"name":"R. Blake Buchalter","orcid":"0000-0003-3605-904X","position":0,"is_corresponding":true}],"reference_count":52,"raw_metadata":null,"created_at":"2026-07-19T02:50:12.083054Z","pmid":"40961032","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}