Perceived accessibility and self-rated health: Examining subjective well-being in the suburbs of Scarborough, Canada

Abstract

Addressing inadequate accessibility in suburban areas is crucial for reducing inequalities in transportation and improving suburbanites’ well-being. Afterall, insufficient accessibility to health is linked to worse health conditions. Moreover, urban sprawl, subpar transit, and automobile dependency prevail in suburbs, making them loci of inequalities in accessibility and, consequently, of potential worse health outcomes for residents. Due to their predictive capacity, subjective health indicators have been extensively researched. Knowledge on Self-Rated Health’s (SRH) link to accessibility in suburbs, however, is incomplete because the field seldom considers individuals’ perceptions. This article examines the association between accessibility and SRH in suburban areas. Using ordinal logistic regressions and data from a survey in Scarborough, Canada, we investigate if accessibility measures estimated from land-use and transportation network data (estimated measures), perceived accessibility, and perceptions of the built environment are associated with SRH. We explore these connections with different domains of SRH (mental, physical and overall). We find that living in areas with higher estimated accessibility measures is positively correlated with better SRH, whereas unsatisfactory perceived accessibility is negatively associated. Additionally, suburbanites who prioritize access to healthcare nearby have lower odds of having better health, meaning that residents who would like to see healthcare access improve are more likely to have worst SRH. Estimated measures are positively associated with self-rated mental health, while reporting difficulty in paying for transport is negatively associated with physical health. These findings stress how multiple components of accessibility – from estimated to perceived measures– can be associated with people’s well-being. Results illuminate the relevance of considering perceptions, often overlooked, in accessibility and health analysis. Finally, the results put into question if suburbanites’ heterogenous needs are recognized in urban design in a context of recent suburbanization of poverty.