Global maps of travel time to emergency and tertiary hospitals

Physics > Physics and Society
[Submitted on 11 Sep 2026]
Title:Global maps of travel time to emergency and tertiary hospitals
View PDF HTML (experimental)Abstract:Global estimates of access to health care treat every facility alike. Drive time was routed on the OpenStreetMap network from all 217,841 of its hospitals and 15-, 30- and 60-minute isochrones dissolved for nested capability tiers, weighted with GHS-POP 2025. 96.2% of the world's population lives within an hour's drive of a hospital, 78.5% of a hospital with a documented emergency department, and 40.3% of one with a helipad or university name marking tertiary care. The 1.45 billion people within an hour of a hospital but not of an emergency hospital live mainly in South and East Asia and Nigeria; the 312 million beyond an hour of any hospital lie in a belt from the Sahel to Madagascar. Defining the tertiary tier by helipad alone leaves its estimate unchanged, and the isochrone construction shifts the 60-minute figures by a few percent. Counting every facility as equivalent overstates access to time-critical care.
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Facts Only

* Global estimates use drive time routed on the OpenStreetMap network from all 217,841 hospitals.
* Isochrones for 15, 30, and 60 minutes were dissolved for nested capability tiers.
* Estimates are weighted with GHS-POP 2025.
* Ninety-six point two percent of the world's population lives within an hour's drive of a hospital.
* Seventy-eight point five percent of hospitals have a documented emergency department.
* Forty point three percent of hospitals have a helipad or university name marking tertiary care.
* One point four five billion people live within an hour of a hospital but not an emergency hospital, mainly in South and East Asia and Nigeria.
* Three hundred twelve million people lie beyond one hour of any hospital, spanning from the Sahel to Madagascar.
* Defining tertiary tier by helipad alone leaves estimates unchanged.

Executive Summary

Global estimates of access to healthcare are based on travel time calculations across the OpenStreetMap network, using isochrones derived from hospital locations and weighted by GHS-POP 2025 data. Ninety-six point two percent of the world's population lives within an hour's drive of a hospital. Furthermore, seventy-eight point five percent of hospitals have a documented emergency department, and forty point three percent of hospitals possess either a helipad or a university name indicating tertiary care status. The analysis suggests that the 1.45 billion people living within an hour of a hospital but outside the range of an emergency hospital primarily reside in South and East Asia and Nigeria. An additional three hundred twelve million people are located beyond one hour of any hospital, spanning from the Sahel to Madagascar. The text cautions that defining tertiary care solely by helipad presence yields unchanged estimates, and constructing isochrones alters the 60-minute figures slightly. The overall conclusion is that counting every facility equally overstates access to time-critical care.

Full Take

The presentation of global access metrics immediately frames healthcare proximity as a quantitative spatial problem rather than an issue of systemic distribution or quality. The core tension lies between aggregate statistics and lived experience, particularly when the methodology forces all facilities into comparable time-based buckets. The calculation’s reliance on OpenStreetMap data acknowledges a real-world mapping reality but simplifies complex socio-economic realities into network distances, weighted by population density projections from 2025. This invites scrutiny over what constitutes "access"—is it mere proximity to a facility, or access to functionally equivalent care within an acceptable timeframe? The explicit warning that counting every facility as equivalent overstates access forces consideration of differential access based on the type and quality of facilities present (e.g., emergency versus tertiary). The pattern suggests that official metrics risk obscuring deep geographical disparities by relying on generalized routing models, potentially masking areas where crucial time-critical care is functionally absent despite physical proximity. The implications point toward a need for methodologies that incorporate capability tiers rather than assuming uniform access based on simple travel distance. What criteria should be used to weigh the value of a 30-minute drive versus a 60-minute drive when considering emergency scenarios? How does this spatial categorization affect policy decisions regarding resource allocation in geographically diverse regions like the Sahel and Madagascar?