Skip to main content
SpringerLink
Log in

An Index of Household Accessibility to Basic Services: A Study of Italian Regions

  • Published:
Social Indicators Research Aims and scope Submit manuscript

Abstract

The level of accessibility to basic services is an important issue because it is closely related to social inclusion and social capital, key aspects of societal well-being. There is a large and growing literature on access to health care in an era of dwindling public resources due to recent economic downturns. Health care is an essential service, but it is not the only basic service. The literature on access to basic services including, but not limited to, health care is relatively small. The paper aims at contributing to the literature by providing a new index to measure and monitor household accessibility to basic services. A study of Italian regions is presented. It is shown that northern regions have more accessible basic services than central, southern and island regions. A longitudinal comparison has been performed. The results are very worrying because show that policy makers have failed in reducing regional (and in particular north–south) disparities in basic service accessibility. Measuring and monitoring the level of accessibility is central for an adequate provision of basic services and for exploring how the delivery of basic services in the most problematic regions can be improved.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Andersen, R. M., Yu, H., Wyn, R., Davidson, P. L., Brown, E. R., & Teleki, S. (2002). Access to medical care for low-income persons: How do communities make a difference? Medical Care Research and Review, 59, 384–411.

    Article  Google Scholar 

  • Atkinson, A. B., Marlier, E., & Nolan, B. (2004). Indicators and targets for social inclusion in the European Union. Journal of Common Market Studies, 42, 47–75.

    Article  Google Scholar 

  • Balarajan, Y., Selvaraj, S., & Subramanian, S. (2011). Health care and equity in India. The Lancet, 377, 505–515.

    Article  Google Scholar 

  • Boccuzzo, G., & Gianecchini, M. (2014). Measuring young graduates job quality through a composite indicator. Social Indicators Research. doi:10.1007/s11205-014-0695-6.

  • Burr, J. A., Mutchler, J. E., & Warren, J. P. (2005). State commitment to home and community-based services: Effects on independent living for older unmarried women. Journal of Aging & Social Policy, 17, 1–18.

    Article  Google Scholar 

  • Choi, S. (2015). How does satisfaction with medical care differ by citizenship and nativity status?: A county-level multilevel analysis. The Gerontologist, 55, 735–747.

    Article  Google Scholar 

  • Dasgupta, P. (2000) Valutation and evaluation: Measuring the quality of life and evaluating policy. LSE STICERD, 22. Available at SSRN: http://ssrn.com/abstract=1126991. Accessed February 15, 2016.

  • Demaerschalk, M. F., Vanden Boer, L. E., Bronselaer, J. L., Molenberghs, G., & Declercq, A. G. (2013). The influence of municipal characteristics on the use of informal home care and home care services by the elderly Flemish. The European Journal of Public Health, 23, 241–246.

    Article  Google Scholar 

  • Dickes, P., & Valentova, M. (2013). Construction, validation and application of the measurement of social cohesion in 47 European countries and regions. Social Indicators Research, 113, 827–846.

    Article  Google Scholar 

  • Elkin, E. B., Ishill, N. M., Snow, J. G., Panageas, K. S., Bach, P. B., Liberman, L., et al. (2010). Geographic access and the use of screening mammography. Medical Care, 48, 349–356.

    Article  Google Scholar 

  • European Union. (2016). European Regional Development Fund. http://ec.europa.eu/regional_policy/en/funding/erdf. Accessed February 15, 2016.

  • European Union. (2016). Cohesion Fund. http://ec.europa.eu/regional_policy/en/funding/cohesion--fund. Accessed February 15, 2016.

  • European Union. (2016). Beyond GDP: Measuring progress, true wealth, and the well–being of nations. http://ec.europa.eu/environment/beyond_gdp/index_en.html. Accessed February 15, 2016.

  • Fayers, P. M., & Hand, D. J. (2002). Causal variables, composite indicators and measurement scales: An example from quality of life. Journal of the Royal Statistical Society Series A, 165, 233–261.

    Article  Google Scholar 

  • Hagerty, M. R., & Land, K. C. (2007). Constructing summary indices of quality of life. Sociological Methods & Research, 35, 455–496.

    Article  Google Scholar 

  • Harris, B., Goudge, J., Ataguba, J. E., McIntyre, D., Nxumalo, N., Jikwana, S., et al. (2011). Inequities in access to health care in South Africa. Journal of Public Health Policy, 32, S102–S123.

    Article  Google Scholar 

  • Hendryx, M. S., Ahern, M. M., Lovrich, N. P., & McCurdy, A. H. (2002). Access to health care and community social capital. Health Services Research, 37, 85–101.

    Article  Google Scholar 

  • Hoskins, B., Saisana, M., & Villalba, C. M. H. (2014). Civic competence of youth in Europe: Measuring cross national variation through the creation of a composite indicator. Social Indicators Research. doi:10.1007/s11205-014-0746-z.

  • Italian Ministry of Health. (2016). LEA (Livelli essenziali di assistenza: basic level of medical assistance). www.salute.gov.it/portale/temi/p2_5.jsp?area=programmazioneSanitariaLea&menu=lea. Accessed February 15, 2016.

  • Italian National Institute of Statistics. (2015). Aspetti della vita quotidiana. www.istat.it/it/archivio/129916. Accessed February 15, 2016.

  • Italian National Institute of Statistics. (2016). BES (Benessere Equo e Sostenibile: Equitable and sustainable well-being). http://www.istat.it/en/files/2015/03/bes. Accessed February 15, 2016.

  • Janes, C. R., Chuluundorj, O., Hilliard, C. E., Rak, K., & Janchiv, K. (2006). Poor medicine for poor people? Assessing the impact of neoliberal reform on health care equity in a post-socialist context. Global Public Health, 1, 5–30.

    Article  Google Scholar 

  • Kentikelenis, A., Karanikolos, A., Papanicolas, A., Basu, S., McKee, M., & David Stuckler, B. (2011). Health effects of financial crisis: Omens of a Greek tragedy. The Lancet, 378, 1457–1458.

    Article  Google Scholar 

  • Kirby, J. B., & Kaneda, T. (2005). Neighborhood socioeconomic disadvantage and access to health care. Journal of Health and Social Behavior, 46, 15–31.

    Article  Google Scholar 

  • Kirby, J. B., & Kaneda, T. (2006). Access to health care: Does neighborhood residential instability matter? Journal of Health and Social Behavior, 47, 142–155.

    Article  Google Scholar 

  • Lago, A., & Pesarin, F. (2000). Nonparametric combination of dependent rankings with application to the quality assessment of industrial products. Metron, 58, 39–52.

    Google Scholar 

  • Lasser, K. E., Himmelstein, D. U., & Woolhandler, S. (2006). Access to care, health status, and health disparities in the United States and Canada: Results of a cross-national population-based survey. American Journal of Public Health, 96, 1300–1307.

    Article  Google Scholar 

  • Lehnert, T., Leicht, H., Heinrich, S., Corrieri, S., Luppa, M., Riedel-Heller, S., et al. (2011). Review: Health care utilization and costs of elderly persons with multiple chronic conditions. Medical Care Research and Review, 68, 47–75.

    Article  Google Scholar 

  • Marozzi, M. (2009). A composite indicator dimension reduction procedure with application to university student satisfaction. Statistica Neerlandica, 63, 258–268.

    Article  Google Scholar 

  • Marozzi, M. (2012). Tertiary student satisfaction with socialization: A statistical assessment. Quality and Quantity, 46, 1271–1278.

    Article  Google Scholar 

  • Marozzi, M. (2014). Construction, dimension reduction and uncertainty analysis of an index of trust in public institutions. Quality and Quantity, 48, 939–953.

    Article  Google Scholar 

  • Marozzi, M. (2015). Measuring trust in European public institutions. Social Indicators Research, 123, 879–895.

    Article  Google Scholar 

  • Marozzi, M. (2016). Construction, robustness assessment and application of an index of perceived level of socio-economic threat from immigrants: A study of 47 European countries and regions. Social Indicators Research, 128, 413–437.

    Article  Google Scholar 

  • Marozzi, M., & Bolzan, M. (2016). Skills and training requirements of municipal directors: a statistical assessment. Quality and Quantity, 50, 1093–1115.

    Article  Google Scholar 

  • Masseria, C., & Giannoni, M. (2010). Equity in access to health care in Italy: A disease-based approach. The European Journal of Public Health, 20, 504–510.

    Article  Google Scholar 

  • McLafferty, S. L. (2003). GIS and health care. Annual Review of Public Health, 24, 25–42.

    Article  Google Scholar 

  • Mechanic, D. (2002). Disadvantage, inequality, and social policy. Health Affairs, 21, 48–59.

    Article  Google Scholar 

  • Meng, Q., Xu, L., Zhang, Y., Qian, J., Cai, M., Xin, Y., et al. (2012). Trends in access to health services and financial protection in China between 2003 and 2011: A cross-sectional study. Lancet, 379, 805–814.

    Article  Google Scholar 

  • OECD (2008) Handbook on constructing composite indicators. www.oecd.org/std/42495745. Accessed February 25, 2016.

  • OECD. (2015). Health at a glance 2015. OECD Indicators. www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm. Accessed February 14, 2016.

  • Pitkin Derose, K., & Varda, D. M. (2009). Social capital and health care access. A systematic review. Medical Care Research and Review, 66, 272–306.

    Article  Google Scholar 

  • Reading, R., & Reynolds, S. (2001). Debt, social disadvantage and maternal depression. Social Science & Medicine, 53, 441–453.

    Article  Google Scholar 

  • Remington, P. L., & Booske, B. C. (2011). Measuring the health of communities—How and why? Journal of Public Health Management & Practice, 17, 397–400.

    Article  Google Scholar 

  • Rosero-Bixby, L. (2004). Spatial access to health care in Costa Rica and its equity: A GIS-based study. Social Science & Medicine, 58, 1271–1284.

    Article  Google Scholar 

  • Saisana, M., Saltelli, A., & Tarantola, S. (2005). Uncertainty and sensitivity analysis techniques as tools for the quality assessment of composite indicators. Journal of the Royal Statistical Society Series A, 168, 307–323.

    Article  Google Scholar 

  • Saisana, M., d’Hombres, B., & Saltelli, A. (2011). Rickety numbers: Volatility of university rankings and policy implications. Research Policy, 40, 165–177.

    Article  Google Scholar 

  • Scheppers, E., van Dongen, E., Dekker, J., Geertzen, J., & Dekker, J. (2006). Potential barriers to the use of health services among ethnic minorities: A review. Family Practice, 23, 248–325.

    Article  Google Scholar 

  • Snowden, L. R., & McClellan, S. R. (2013). Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients. American Journal of Public Health, 103, 1628–1633.

    Article  Google Scholar 

  • Trani, J. F., & Barbou-des-Courieres, C. (2012). Measuring equity in disability and healthcare utilization in Afghanistan. Medicine, Conflict and Survival, 28, 219–246.

    Article  Google Scholar 

  • Van Doorslaer, E., Masseria, C., & Koolman, X. (2006). Inequalities in access to medical care by income in developed countries. Canadian Medical Association Journal, 174, 177–183.

    Article  Google Scholar 

  • Waites, C. (2013). Examining the perceptions, preferences, and practices that influence healthy aging for African American older adults. Journal of Applied Gerontology, 32, 855–875.

    Article  Google Scholar 

  • Wight, R. G., Cummings, J. R., Karlamangla, A. S., & Aneshensel, C. S. (2010). Urban neighborhood context and mortality in late life. Journal of Aging and Health, 22, 197–218.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Environmental Sciences, Informatics and Statistics, Ca’ Foscari University of Venice, Via Torino 155, 30172, Venezia Mestre, Italy

    Marco Marozzi

  2. Department of Statistical Sciences, University of Padua, Via Battisti 241, 35121, Padova, Italy

    Mario Bolzan

Authors
  1. Marco Marozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mario Bolzan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Marozzi.

Additional information

Sections 1, 2, 3 and 5 have to be attributed to M. Marozzi. Section 4 has to be attributed equally to M. Marozzi and M. Bolzan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marozzi, M., Bolzan, M. An Index of Household Accessibility to Basic Services: A Study of Italian Regions. Soc Indic Res 136, 1237–1250 (2018). https://doi.org/10.1007/s11205-016-1440-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11205-016-1440-0

Keywords

Search

Navigation