Year: 2026
Type: dissertation
Abstract: This dissertation investigates how population dynamics and healthcare accessibility interact in high-altitude mountainous regions of western China, where rugged terrain, sparse settlements, and fragile ecosystems pose persistent challenges to health equity.Building on a unified "population-health-space" coupling framework, the thesis links three empirical cases across multiple scales.First, county-level analysis of 42 high-altitude counties in Sichuan develops a Sustainable Population Migration Index (SPMI) based on geodetector-derived drivers, showing that healthcare accessibility is the dominant determinant of resident and rural population change, and that migration attractiveness generally deteriorated between 2010 and 2020.Second, a benchmark assessment of primary healthcare facilities in nine large-relief alpine counties in Tibet reveals severe shortfalls in 15-minute coverage, over-reliance on county hospitals, and pronounced inequities between townships and villages despite nominal improvements in supply.Third, the thesis proposes a Multi-Factor Integrated Mountain Walkability Model (MIMWM) embedded in a Two-Step Floating Catchment Area (2SFCA) framework for Diqing Prefecture, integrating slope-adjusted walking speeds, land-use resistance, and altitude-related physiological decline.Results show that conventional Euclidean and network methods systematically overestimate accessibility, that a critical threshold occurs around 30 minutes of walking time, and that most residents fall below national baseline standards when terrain constraints are fully considered.Synthesizing the three case studies, the dissertation demonstrates that terrain-sensitive, near-distance accessibility is central to stabilizing high-altitude populations, and that decentralized facility siting, micro-scale walking infrastructure, and digital-twin-based scenario tools are effective levers for improving rural health equity in mountainous environments.
Author: ドン, シャンユー
Language: English
Subfield: Transportation
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7222775950