Geospatial Disparities in Elderly Health: A GIS-Based Study of Functional Independence in Tasikmalaya Regency, Indonesia

Abstract

Population ageing poses significant challenges to healthcare access, particularly in rural areas with varied topography. This study examines geographical health inequalities among single elderly women in Tasikmalaya Regency, West Java, Indonesia a region characterized by rugged terrain and inadequate infrastructure. Using a mixed-methods approach, we assessed the functional health of 383 women aged 60 and above through the Activities of Daily Living (ADL) index and analyzed spatial access to healthcare facilities using Geographic Information System (GIS) based tools, including isochrone mapping and spatial regression. The findings reveal substantial limitations in instrumental activities despite preserved independence in basic self-care. Spatial analysis shows that lower ADL scores are concentrated in highland areas, associated with higher elevations and longer distances to healthcare services. However, proximity to health centers alone does not consistently predict functional status, suggesting that broader social complexities also influence health outcomes. These results underscore the need for geography sensitive healthcare policies such as mobile clinics, improved transportation infrastructure, and community-based support systems to reduce disparities and enhance the well-being of elderly women in remote areas.