Evaluating medical convenience in ethnic minority areas of Southwest China via road network vulnerability: a case study for Dehong autonomous prefecture.

Background: Southwest China is home to more than 30 ethnic minority groups. Since most of these populations reside in mountainous areas, convenient access to medical services is an important metric of how well their livelihoods are being protected.
Methods: This paper proposes a medical convenience index (MCI) and computation model for mountain residents, taking into account various conditions including topography, geology, and climate. Data on road networks were used for comprehensive evaluation from three perspectives: vulnerability, complexity, and accessibility. The model is innovative for considering road network vulnerability in mountainous areas, and proposing a method of evaluating road network vulnerability by measuring the impacts of debris flows based on only links. The model was used to compute and rank the respective MCIs for settlements of each ethnic population in the Dehong Dai and Jingpo Autonomous Prefecture of Yunnan Province, in 2009 and 2015. Data on the settlements over the two periods were also used to analyze the spatial differentiation of medical convenience levels within the study area.
Results: The medical convenience levels of many settlements improved significantly. 80 settlements were greatly improved, while another 103 showed slight improvement.Areas with obvious improvement were distributed in clusters, and mainly located in the southwestern part of Yingjiang County, northern Longchuan County, eastern Lianghe County, and the region where Lianghe and Longchuan counties and Mang City intersect.
Conclusions: Development of the road network was found to be a major contributor to improvements in MCI for mountain residents over the six-year period.