Spatial Disparities in Housing and Healthcare Access: Implications for Public Health in Lagos

Abstract

Rapid urbanization in Sub-Saharan African cities has exerted extreme pressure on municipal infrastructures, widening spatial inequalities in access to basic services. This study examines spatial disparities in housing quality and healthcare access across Lagos, Nigeria, and analyzes their implications for public health. Adopting a mixed-method research design, we clean and analyze primary survey data (N = 142) collected via ArcGIS Survey123 and analyze the spatial and socioeconomic associations using SPSS-equivalent non-parametric and categorical tests. The spatial distribution analysis reveals that infrastructural deficits are metropolitan-wide rather than a simple Mainland-Island divide, with no statistically significant differences in housing type between the regions (p = 1.00) or healthcare distance proximity (p = 0.312). Affordability of both housing and healthcare represents a systemic crisis that affects formal and informal workers alike, showing no significant association with occupational or educational status (p > 0.05). Spearman correlation indicates that perceived urbanization pressures are strongly associated with poor health outcomes (rho = 0.377, p < 0.001) and limited healthcare access (rho = 0.373, p < 0.001). Crucially, a Wilcoxon Signed-Rank Test demonstrates a highly significant spatial-quality gap (W = 448.0, p < 0.001): while facilities are geographically close (Mean = 3.65), their quality in terms of equipment and staffing is severely deficient (Mean = 2.73). Furthermore, higher-educated residents express significantly greater skepticism toward the efficacy of government urban policies than those with basic education (p = 0.035). We recommend targeted slum upgrading, enforced spatial equity in infrastructure development, and public-private partnerships to improve healthcare quality in peripheral neighborhoods.