One in five with limited public transit access have deferred care

Photo: Thomas Bonfert/Getty Images

While private motor vehicles are the primary form of transportation in the U.S., many people – including those in urban areas, Black or Hispanic people, and those with low incomes – rely on public transportation. This is troubling news in healthcare terms, because a new survey from the Robert Wood Johnson Foundation has found that about 5% of adults haven't received needed healthcare within the past year because of difficulty finding transportation.

This experience was more common with low-income families (14%), adults with disabilities (17%), those with public health insurance coverage (12%) and adults without household access to a vehicle (13%).

While 91%of adults reported having household access to a vehicle, this figure was substantially lower among Black adults (81%), adults with low family incomes (78%), adults with a disability (83%) and adults with public health insurance (79%) or no health insurance coverage (83%).

Adults without access to a vehicle who reported living in neighborhoods with fair or poor access to public transit were significantly more likely to forgo needed healthcare because of difficulty finding transportation (21%) compared with their counterparts reporting excellent, very good or good neighborhood access to public transit (9%).

WHAT'S THE IMPACT?

The findings add to the growing body of evidence that inequitable access to transportation perpetuates disparities in access to healthcare, highlighting the importance of transportation as a social determinant of health.

Public transit systems – which may include buses, subways, rails, light rails and ferries – are designed to facilitate transportation for the general public. Research from University at Albany has shown public transit systems promote health by reducing air pollution, promoting physical activity, reducing motor vehicle crashes and increasing access to food, jobs and recreation.

The RWJ survey takes that a step further, finding that access to public transportation is associated with improved access to healthcare itself – consistent with prior research finding that expansions to public transit systems result in fewer missed appointments.

THE LARGER TREND

The authors said the findings highlight the importance of public transit accessibility in promoting equitable access to healthcare for states, local governments and other stakeholders to consider when weighing investments in public transit. 

Policymakers may also consider expanding transportation benefits in health insurance plans – such as the Non-Emergency Medical Transportation benefit in Medicaid, which varies considerably across and within states – to include coverage of public transit fares.

Additionally, maintaining expanded coverage of telehealth services, even when the COVID-19 public health emergency ends, may promote access to care for those facing transportation barriers, the authors said.
 

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com