Subsidized housing and geographic accessibility to neighborhood resources for low-income older people: From later year social exclusion perspective

Objectives: Drawing on the perspective of later year social exclusion, this study (1) assessed geographic accessibility to health and social services in subsidized senior housing in Chicago. (2) examined the association between senior housing's accessibility to health/social services, and social exclusion at the neighborhood level. Methods: First, senior housing and social/health services data were geocoded and spatially merged with all accessible streets/roads in Chicago area. Second, using network analysis, an advanced GIS technique, we compared degree of accessibility based on the standardized distribution of health and social resources. Third, to examine social exclusion at a neighborhood level, we conducted an exploratory principal component analysis (PCA) to construct a composite score of social exclusion. Last, we ran bivariate analyses (ANOVA) to examine the association between service accessibility and social exclusion components. Results: There were 102 subsidized senior housing facilities, surrounded by 120 health service agencies and social services, including 80 libraries, 21 senior centers, and 28 family and support services. PCA analysis revealed five components from the original 16 social exclusion indicators: socio-economic disadvantage, low social integration, environmental hazard, lack of service availability marginalization. The socio-health accessibility was significantly related to two social exclusion factors: socio-economic disadvantage and low social integration. Discussion: As the first study based on a geospatial approach that focuses on subsidized senior housing's accessibility neighborhood resources, our findings showed that subsidized senior housing not only has differential levels of service, but more importantly is embedded in a qualitatively different nature of social exclusion at neighborhood level.