Current Research on Geography, Earth Science and Environment Vol. 9

Geographic information systems are widely used to identify populations with limited access to healthcare, but spatial proximity does not necessarily represent access to appropriate, affordable and timely care. This distinction is particularly consequential for older adults, whose healthcare requirements, functional abilities, transport resources and support networks vary substantially. This critical narrative review examines how geographic information systems measure healthcare accessibility and how the resulting estimates should be interpreted when assessing inequalities in later life. Targeted searches of openly accessible scholarly indexes, regional sources and citation networks covered literature published from 2000 to 29 July 2026. Foundational methodological studies, age-specific applications and complementary evidence on healthcare utilisation and digital access were critically compared. The synthesis distinguishes potential spatial access, feasible access under individual constraints, realised utilisation and effective care. Floating catchment area methods provide useful representations of the interaction between service capacity, population demand and travel impedance, but their outputs depend on assumptions about competition, catchment boundaries, transport modes and facility eligibility. Evidence from different regions repeatedly identifies peripheral and transport-disadvantaged populations with poorer modelled access, although the relative position of urban centres and service tiers changes with population competition and analytical choices. Associations with utilisation are inconsistent, and observational accessibility maps cannot establish that relocating facilities improves health. Age-only demand measures, incomplete facility registers, residential aggregation and inadequate representation of people unable to travel are persistent threats to validity. Recent high-resolution datasets and mobility-informed models improve analytical possibilities without resolving these problems automatically. An interpretive framework is proposed that separates need, feasible journeys, eligible service capacity, realised care and outcomes rather than combining them into an undifferentiated score. Priorities include independent journey validation, inclusion of homebound populations, uncertainty-aware planning and prospective evaluation of service and transport interventions. Geographic analysis is most defensible as one component of an accountable, person-centred assessment of healthcare equity.