Publication Date


Advisor(s) - Committee Chair

Dr. Jun Yan (Director), Dr. Margaret Gripshover, Dr. David Keeling, Dr. Thomas Bell

Degree Program

Department of Geography and Geology

Degree Type

Master of Science


The growing concern for the shortage of primary care physicians (PCPs) prompted a government legislation to designate areas where shortage in the delivery of primary care services occurs. The implemented systems (e.g., HPSA, MUA, and MUP) analyze utilization of health services within confined administrative units and fail to account for spatial interactions that occur across administrative borders. This research examines the spatial accessibility to PCPs and the underlying demographic and socioeconomic settings. With the Nashville Metropolitan Statistical Area (MSA) as a study area, this study utilized data from the U.S. Census 2000 and 2010, as well as the known locations of (PCPs) collected in 2010. Geographic Information Systems (GIS) provided the tools by which the processing and analysis of the data was carried out. Specifically, network analysis was applied to estimate travel time and service area coverage. A Two-Step Floating Catchment Area (2SFCA) method was implemented to measure spatial accessibility to PCPs. This method was applied to measure accessibility at the level (census block) that most accurately represents the spatial population of the Nashville MSA. In addition, this research implemented several distance-decay functions in addition to the dichotomous function of the standard 2SFCA method. This research has found that the majority of the population residing in the Nashville MSA enjoyed good spatial accessibility to PCPs. However, the highest percentages of those resided in areas of low accessibility were located in periphery rural areas as well as isolated areas poorly connected to the roadway network due to certain physical barriers such as lakes and streams. Moreover, this research has found that, in general, non-spatial factors intensified the most where there was good accessibility to PCPs.


Geographic Information Sciences | Health and Medical Administration | Medical Sciences