Geospatial disparities in emergency medical utilization and neighborhood-level socioeconomic status in Yamato City, Japan.

OBJECTIVE

Neighborhood-level socioeconomic disparities are becoming more apparent in Japan; however, their relationship with emergency medical utilization remains unclear.

METHODS

This cross-sectional study was conducted in Yamato City, a suburban municipality near Tokyo. The city was divided into nine daily living districts based on the jurisdictions of Regional Comprehensive Support Centers. Demographic and socioeconomic indicators were obtained from municipal statistics for June 2025 and the 2020 national census. Data on 1199 ambulance transports, including 953 city residents, during secondary emergency duty from April 2024 to March 2026, were extracted from our hospital's medical records.

RESULTS

The proportions of residents aged ≥65 and ≥75 years, nursing care certification rate, welfare recipient rate, ambulance transport rate, emergency hospitalization rate, and areal deprivation index (ADI) showed a consistent north-south geographic gradient, with higher values in the southern area. Both ambulance transport and emergency hospitalization rates were positively correlated with ADI across the nine districts. The southern area had the highest ambulance transport rate for fall-related injuries, particularly among women.

CONCLUSIONS

Neighborhood-level socioeconomic disadvantage was associated with ambulance transport and emergency hospitalization in a Japanese suburban city. Tailored public health strategies may help optimize the emergency medical care system in resource-limited settings.