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ORIGINAL RESEARCH article

Front. Public Health

Sec. Aging and Public Health

This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health Welfare, Volume IIView all 24 articles

Agent-Based Modeling of Health Resources for Older Adults: Accessibility, Equity, and Last-Mile Solutions in Fuzhou, China

Provisionally accepted
Qiuyi  ZhangQiuyi Zhang1*Xin  WuXin Wu1Siying  WuSiying Wu1Liyun  HuangLiyun Huang2*Chong  PengChong Peng1*
  • 1Fujian University of Technology, Fuzhou, China
  • 2Chongqing University Key Laboratory of New Technology for Construction of Cities in Mountain Area, Chongqing, China

The final, formatted version of the article will be published soon.

Population aging presents a critical challenge for urban sustainability and health equity. This study addresses the structural mismatch between the spatial distribution of older adults and health resources in Fuzhou, China, by developing an Agent-Based Model (ABM) to simulate the utilization of prevention, treatment, and long-term care facilities and its impact on health outcomes. The model, grounded in empirical questionnaire data and real-world spatial data, incorporates older adults as mobile agents with diverse health, economic, and living statuses, navigating a realistic urban environment over a 500-day simulation. This research designed a conceptual framework capturing the dynamic feedback between facility usage and health status. Four intervention scenarios, Multi-functional Community Centers (S1), Senior-Friendly Transportation Policies (S2), Community-based Health Education (S3), and a Comprehensive package (S4), were tested. Results indicate that spatial accessibility is the paramount driver of health improvement, with S2 (transport support) and S4 (comprehensive) demonstrating the most significant and rapid gains. Health equity, assessed via a weighted Gini coefficient, showed that while S4 achieved the most robust equity improvements across health and economic strata, its effect on residential disparities was limited. S1 risked exacerbating inequities if not precisely targeted, and S3 showed the least efficacy. The study concludes that optimizing health resources for aging populations requires a spatially-anchored, multi-dimensional strategy that prioritizes transportation accessibility, precision facility siting, and integrated service provision to effectively overcome "last-mile" barriers and address the complex needs of socioeconomically diverse older adults.

Keywords: Agent-based modeling, Older adults Health Equity, Spatial accessibility, Urban Health Planning, Fuzhou's main urban area

Received: 04 Sep 2025; Accepted: 30 Oct 2025.

Copyright: © 2025 Zhang, Wu, Wu, Huang and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Qiuyi Zhang, zhangqy@fjut.edu.cn
Liyun Huang, 16397562@qq.com
Chong Peng, pengchong@fjut.edu.cn

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