Nationwide equity assessment of the 20-min neighbourhood in the scottish context: A socio-spatial proximity analysis of residential locations

The 20-min neighbourhood (20 MN) is a method of designing neighbourhoods in such a way that individuals can meet the majority of their daily needs within a 10-min walk (therefore a 20-min return trip) of their home. The Scottish Government have committed to apply the 20 MN concept nationwide, focusing on disadvantaged communities. The aims of this study were to: (1) create 20 MN catchment areas for health, transport, education, social and recreational domains; (2) describe the number of residential locations within 20 MN domain catchment areas; and (3) describe variation in access to 20 MN domains by area-level socioeconomic status and urbanicity. 20 MN catchment areas (800-m) were created for 10 domains using road and path network analysis. All Scottish residential locations (n:146,190) were plotted, assigned area-level socioeconomic status and urbanicity. A dichotomised (yes/no) variable was created to identify whether it was within a 10-min walk of individual 20 MN domains. One in five residential locations had access to all 10 20 MN domains (Urban: 28%, Rural: 5%). There was variation in proportion of residential locations that has access to at least one facility by domains; 91% had access to at least one public transport stop and 84% a public open space. There was poorer access to primary care services (42%) and healthy food retailers (50%). Across all domains, access to at least one facility was greater within the most deprived areas. Access to 20 MN domains was greatest in areas where individual health status tends to be worse. A policy focusing solely on improving access to key facilities and amenities for deprived areas may be ineffective in reducing health inequalities. Future studies should assess the quality of facilities and co-location with health damaging facilities, particularly within more deprived areas. Alternative policy approaches may be required for improving access to facilities and amenities for rural communities.