Geographical Access to Child and Family Healthcare Services and Hospitals for Africa-Born Migrants and Refugees in NSW, Australia; A Spatial Study

Abstract

Background: African-born migrants and refugees arriving from fragile states and countries with political and economic challenges have unique health needs requiring tailored healthcare services and support. However, there is little investigation into the distribution of this population and their spatial access to healthcare in Australia. This paper reports on research that aimed to map the spatial distribution of Africa-born migrants from low and lower-middle-income countries (LLMICs) and refugees in New South Wales (NSW) and access to universal child and family health (CFH) services and hospitals. Methods: We analysed the Australian Bureau of Statistics 2016 Census data and Department of Social Services 2018 Settlement data. Using a Geographic Information System mapping software (Caliper Corporation. Newton, MA, USA), we applied data visualisation techniques to map the distribution of Africa-born migrants and refugees relative to CFH services and their travel distance to the nearest service. Results: Results indicate a spatial distribution of 51,709 migrants from LLMICs in Africa and 13,661 refugees from Africa live in NSW, with more than 70% of the total population residing in Sydney. The Africa-born migrant and refugee population in Sydney appear to be well served by CFH services and hospitals. However, there is a marked disparity between local government areas. For example, the local government areas of Blacktown and Canterbury-Bankstown, where the largest number of Africa-born migrants and refugees reside, have more uneven and widely dispersed services than those in Sydney's inner suburbs. Conclusion: The place of residence and travel distance to services may present barriers to access to essential CFH services and hospitals for Africa-born refugees and migrants. Future analysis into spatial-access disadvantages is needed to identify how access to health services can be improved for refugees and migrants.

Keywords: African; Australia; healthcare; migrants; refugees; spatial-access; vulnerable populations.

Figure 1

The spatial distribution of Africans from LLMICs in NSW at the statistical-area level 2 (SA2) level, ABS Census data 2016. In the map legend, numbers in parentheses are a count of SA2 areas and those without the migrant population. The inset map is a close-up of the spatial distribution of these population groups in metropolitan areas.

Figure 2

The spatial distribution of migrants from LLMIC and refugee communities relative to a CFH service and/or hospital and their drive distance most travel to access care. The dark coloured areas indicate where most of them live, while the white dots represent the CFH services. Our approach defines travel time using area contours increasing incrementally starting at 5 km travel distance; that means that the inner contour is within 5 km of healthcare service. All areas outside the 5 km zone are shaded, whilst those within a 5 km access level are not shaded. The loops show travel distances within those areas.

Figure 3

The spatial distribution of migrants from LLMICs and refugee communities relative to a CFH service. The vertically striped greyed areas show SA2 areas where the African population is greater than 49 people and pockets of residential areas where the nearest healthcare service is further than a 5 km drive.