Feasibility of health tourism capacities in Maragheh city with emphasis on sustainable urban development

Subject Areas : Sustainable urban development

Ali Azar ^{1 *} , Roghayeh Saidi ²

1 - Assistant Professor, Department of Architecture and Urban Planning, Maragheh Branch, Islamic Azad University, Maragheh, Iran.
2 - PhD in urban planning and Maragheh Branch، Islamic Azad University، Maragheh، Iran.

Received: 2022-11-30 Accepted : 2023-03-10 Published : 2023-06-22

Keywords: health tourism, Feasibility Study, therapeutic tourism, Sustainable Urban Development, Maragheh,

Abstract :

With the development of urbanization and increasing mental pressures, citizens have also experienced increasing physical diseases. In this connection, health tourism assumes greater importance for people to use health and hygienic facilities. One of the areas in which cities compete with each other is their capability of attracting domestic and foreign treatment tourists. The level of reference and stay of health tourists is considerably highest than other tourists, and this indicates the significance of health tourism. The health tourism sector is one of the principal components of urban economic strength that guarantees residents’ quality of life. The aim of the present study was to measure the feasibility of health tourism capacities in the city of Maragheh using sustainable urban development. The study was an applied study and fell under the quantitative and qualitative research. The data were obtained by using documentary and observational studies via a researcher-made questionnaire. Health tourism evaluation criteria included 27 variables of social-cultural, economic, and environmental (ecological) components. The statistical population of the study consisted of 384 people who were present at health tourism places.  To analyze the data, the structural equation modeling and SPSS, AMOS, and MPLUS software were used. Findings revealed that the component of tourism economics with the factor loading of 0.95 held the highest effects on the sustainable health tourism, and the component of local culture (factor loading of 0.63), terminal equipment (factor loading of 0.62) held the lowest effects. As well, the component5 of sustainable tourism with the direct and indirect effects of 0.815 and 0.131 held the highest effects, while the component of the environment with the direct and indirect effects of 0.634 and 0.164 held the lowest effects on the development of sustainable tourism in the city of Maragheh. The economic component with the direct and indirect effects and the component of social-cultural with the direct and indirect effects of 0.702 and0.105 also contributed to the development of sustainable health tourism in the city.  Exteded Abstract Introduction With the development of urbanization and increasing mental pressures, citizens have also experienced increasing physical diseases. In this connection, health tourism assumes greater importance for people to use health and hygienic facilities. One of the areas in which cities compete with each other is their capability of attracting domestic and foreign treatment tourists. The level of reference and stay of health tourists is considerably highest than other tourists, and this indicates the significance of health tourism. The health tourism sector is one of the principal components of urban economic strength that guarantees residents’ quality of life. The aim of the present study was to measure the feasibility of health tourism capacities in the city of Maragheh using sustainable urban development. Here, this study focuses on the eco-tourism and water-therapy dimension of the health tourism sector. Maragheh City enjoys numerous mineral water springs, and thus have favorable capacities in the health tourism sector. This is because of its geomorphological and geographical situation, the presence of expert physicians, being the treatment hub of the province, having centers of accommodation, and types of hotels. Thus, health tourism and the feasibility of infrastructure can affect the diversity of urban economies and employment, thereby producing much-needed currency as the main component of the secondary industry and contribute to the sustainable development. This city is the focal point of the study enjoys potential health tourism capacities (especially water therapy capacities).Methodology The study was an applied study and fell under the quantitative and qualitative research. The data were obtained by using documentary and observational studies via a researcher-made questionnaire. Health tourism evaluation criteria included 27 variables of social-cultural, economic, and environmental (ecological) components. The statistical population of the study consisted of 384 people who were present at health tourism places.  To analyze the data, the structural equation modeling and SPSS, AMOS, and MPLUS software were used.Results and discussionField surveys and results from social-cultural correlation coefficients affecting the sustainable tourism therapy (health tourism) in the city of Maragheh indicated that there was a positive and significant correlation between municipality management component and health tourism sustainability. This suggests that the more the health tourism sector flourishes the more municipality management develops, and the thus the more sustainable health tourism in Maragheh City will be. There was a positive and significant relationship between all social-cultural components and the sustainable health tourism in Maragheh, with the significance level being 0.000 at the alpha rate of 0.05; and since the calculated error rate is less than 0.01, there is a significant relationship between all social-cultural components and the sustainable health tourism at 99% confidence level. Thus, the improvement of all the components from a tourism therapy point of view could lead to sustainable health tourism in the city of Maragheh.Results from the correlation coefficient of components affecting the sustainable tourism therapy (health tourism) in the city of Maragheh indicates that there was a positive and significant relationship between the economic component and the Maragheh’s health tourism sustainability.  ConclusionFindings revealed that the component of tourism economics with the factor loading of 0.95 held the highest effects on the sustainable health tourism, and the component of local culture (factor loading of 0.63), terminal equipment (factor loading of 0.62) held the lowest effects. As well, the component5 of sustainable tourism with the direct and indirect effects of 0.815 and 0.131 held the highest effects, while the component of the environment with the direct and indirect effects of 0.634 and 0.164 held the lowest effects on the development of sustainable tourism in the city of Maragheh. The economic component with the direct and indirect effects and the component of social-cultural with the direct and indirect effects of 0.702 and0.105 also contributed to the development of sustainable health tourism in the city.  It was also found that health tourism could lead to employment (especially when the city of Maragheh holds the highest unemployment rate in the province and the entire country). Findings showed that the most important problems in the city were weak tourism infrastructure, private sector’s investors’ unwillingness to invest, and the lack of support by city officials to increase tourism attractions in the city.

References:

• Abrahams, Z.; Hoogendoorn, G.; Fitchett, J.M. (2022), Glacier tourism and tourist reviews: An experiential engagement with the concept of “Last Chance Tourism”. Scand. J. Hosp. Tour. 22, 1-14.


• Asadi, Ahmed, Zadoli Khajeh, Shahrukh. (2021). Development of a health tourism development model with a future research approach in Tabriz metropolis. Space Geographic Survey, 11(41), 111-126.  (in persian)


• Chakraborty, A. (2022), Geodiversity and Tourism Sustainability in the Anthropocene. Tour. Hosp. 2022, 3, 496-508. https://doi.org/10.3390/tourhosp3020031.


•  


• Chaulagain, S., Pizam, A., & Wang, Y. (2021). An Integrated Behavioral Model for Medical Tourism: An American Perspective. Journal of Travel Research, 60(4), 761-778. https://doi.org/10.1177/0047287520907681


• Choi, Y.; Ashurova, Z.; Lee, H. (2021), Sustainable Governance on the Intention of Medical Tourism in Uzbekistan. Sustainability, 13, 6915. https://doi.org/10.3390/su13126915


• Falah Tafti, Hamed, Dosti Irani, Mahnaz.(2022).Fuzzy cognitive mapping of the effect of online interactions on the loyalty levels of tourists (case study: customers of travel agencies on the Instagram social network).Tourism Management Studies, 17(58), 133-161.Doi (in persian)


• Ghorbani, Rasool, Raushi, Shahrivar, Karbasi, Puran.(2021).The creeping of Maragheh city and land use changes in suburban.Development of Spaces, 3(1), 1-18. (in persian)


• Ghosh, T., & Mandal, S. (2019). Medical tourism experience: Conceptualization, scale development, and validation. Journal of Travel Research, 58(8), 1288-1301. https:// doi. org/ 10. 1177/ 00472 87518 813469.


• Hehir, C.; Scarles, C.; Wyles, K.J.; (2022), Kantenbacher, J. Last chance for wildlife: Making tourism count for conservation. J. Sustain. Tour 55. 1-21. https://doi.org/10.1080/09669582.2022.2049804.


• Jahan Tighmand Somia, Zini Vand Yassin, Mousavi Nadushan Seyedmoin.(2023), spatio-spatial organization of urban river banks with tourism development approach (case example of Poldakhter city).Applied Research of Geographical Sciences, 23 (68): 43-60 (in persian)


• Jiang, Lei; Wu, Huazhang; Song, Yang (2022), Diversified demand for health tourism matters: From a perspective of the intra-industry trade, Social Science & Medicine Volume 293, January 2022, 114630


• Khaksari Rafsanjani, Ali, & Lotfi, Akbar. (2023), Identification and analysis of drivers effective on the development of the urban tourism industry with an emphasis on foresight and scenario writing (case study: Zanjan city). Urban Environment Planning and Development, 2(8), 21-38. doi: 10.30495/juepd.2023.1976932.113


• Lim, Y.J.; Kim, H.K.; Lee, T.J. (2016), Visitor motivational factors and level of satisfaction in wellness tourism: Comparison between first-time visitors and repeat visitors. Asia Pac. J. Tour. Res. 21, 137156.


• Makhmoli, Hassan, Motaghi, Samira, Safari, Azar, Sadeghi, Farzaneh.(1400).The impact of regionalism on health tourism in Muslim countries.Strategic Management Studies Quarterly, 12(46), 59-70. (in persian)


• Malhotra, N., Dave, K. (2022), An Assessment of Competitiveness of Medical Tourism Industry in India: A Case of Delhi NCR. JGBC, 53 (3), 1-14. https://doi.org/10.1007/s42943-022-00060-0.


• Mazrouei Nasrabadi, Esmaili, Mohammadipour, Elham.(2022).Presenting the health tourism supply chain risk model, metacomposite approach and structural-interpretive modeling.Health Information Management, 18(4), 172-181.


• Nemati, Wali, Babaei, Yavar, Ferdowsi, Sajjad, Aghandeh, Mohammad Ali, Abbasqolizadeh, Natiq.(2021).The impact of health tourism on improving the social welfare of the host community.Ardabil Health and Health, 12(2), 208-221. (in persian)


• Pedersen, S.B. (2020), A Passport to Peace? Modern Tourism and Internationalist Idealism. Eur. Rev. 28, 389-402.


• Rachel, Clissold; Westoby, Ross; McNamara, Karen E; Fleming, Christopher (2022),


• Wellbeing outcomes of nature tourism: Mt Barney Lodge, Annals of Tourism Research Empirical Insights, vol 3, pp, 1-


• Shanahan, D. F., Bush, R., Gaston, K. J., Lin, B. B., Dean, J., Barber, E., & Fuller, R. A. (2016) Health benefits from nature experiences depend on dose. Scientific Reports, 6


• (1), 28551. https://doi.org/10.1038/srep28551


• Santos-Roldán, L, Canalejo, A, M. C, Berbel-Pineda, J. M. Palacios-Florencio, B, (2020), Sustainable Tourism as a Source of Healthy Tourism, Int. J. Environ. Res. Public Health 2020, 17(15), 1-14, 5353; doi:10.3390/ijerph17155353. mdpi.com/journal/ijerph.


• Shafiei, Zahra, Mousavi, Seyyed Hojat, Wali, Abbas Ali.(2021).Locating areas susceptible to the development of medical (health) tourism in Aran and Bidgol salt lakes with an emphasis on the construction of a salt therapy site using the AHP method and using GIS.Halal Research Journal, 4(4), 49-67. (in persian)


• Shahpuri, Ahmadreza, Amirnejad, Hamid, Ghorbani, Mohammad.(2022).Coastal tourism model of Mazandaran Sea based on payment for ecosystem services.Agricultural Economics Research, 13(1), 147-174. (in persian)


• Somoza-Medina, X.; Monteserín-Abella, O. (2021), The Sustainability of Industrial Heritage Tourism Far from the Axes of Economic Development in Europe: Two Case Studies. Sustainability,13, 1077. https://doi.org/10.3390/su13031077.


• Szromek, A.R.; Herman, K.; Naramski, M. (2021), Sustainable development of industrial heritage tourism-A case study of the Industrial Monuments Route in Poland. Tour. Manag. 83, 104252.


• Szromek, A.R.; Polok, G. A (2022), Business Model for Spa Tourism Enterprises: Transformation in a Period of Sustainable Change and Humanitarian Crisis. J. Open Innov. Technol. Mark. Complex. 8, 72. https://doi.org/10.3390/joitmc8020072.


• Timakova, V & Maksimeniuk, R, (2021), Sustainable tourism development at the level of health-improving tourism: social-legal aspect, E3S Web of Conferences 296, 05018, 1-6. https://doi.org/10.1051/e3sconf/202129605018. ESMGT 2021


• Wang, K.; Xu, H.; Huang, L. (2020), Wellness tourism and spatial stigma: A case study of Bama, China. Tour. Manag. 78, 104039.


• World Tourism Organization & European Travel Commission (WTO & ETC). (2018), Exploring Health Tourism-Executive Summary; UNWTO: Madrid, Spain.


• Zahmatkesh Sardurahi, Mahdieh, Mohammadpour Shirazi Fatemeh, Ardian Aram, Siadtan Mohammad, Hashemi Seideh Noushin, (2021), factors influencing the promotion of the brand of Yazd as a health tourism destination with a fuzzy cognitive mapping approach, Image of Health, 12(1), 24-33 (in persian)


• Zhong L, Deng B, Morrison AM, Coca-Stefaniak JA, Yang L. Medical, Health and Wellness Tourism Research-A Review of the Literature (1970-2020) and Research Agenda. Int J Environ Res Public Health. 2021 Oct 16;18(20):10875. doi: 10.3390/ijerph182010875. PMID: 34682622; PMCID: PMC8536053.