An Inequality in Spatial Accessibility to Preventive Healthcare Use: A Comparison of Nonimmigrant Older Adults and Older Korean Immigrants in Los Angeles, USA

Abstract

Spatial accessibility to healthcare services is a key determinant of health equity, especially among aging immigrant populations. This study examines disparities in access to preventive healthcare services between older Korean immigrants and nonimmigrant older adults in Los Angeles, USA. Using the generalized two-step floating catchment area (G2SFCA) method, we assess spatial accessibility by considering supply–demand dynamics, travel behavior, and distance-decay effects, which capture the decreasing likelihood of healthcare utilization as travel distance or time increases. The findings indicate that older Korean immigrants experience lower levels of accessibility to preventive healthcare services compared to nonimmigrant older adults, including longer travel distances and more limited availability of linguistically and culturally appropriate services. While nonimmigrant older adults generally have better access, older Korean immigrants often need to travel further to find care that meets their linguistic needs. These disparities highlight the role of geographic, linguistic, and structural barriers in shaping healthcare accessibility. To address these challenges, policy interventions such as increasing Korean-speaking healthcare providers, expanding mobile healthcare services, and improving transportation options are necessary. This study contributes to the discourse on healthcare equity and immigrant health, emphasizing the need for targeted strategies to improve access to preventive care for aging immigrant populations. By addressing gaps in existing accessibility measures for immigrant populations, this study opens avenues for future research that integrates individual-level constraints and qualitative approaches. © 2026 John Wiley & Sons Ltd.