Transportation

Overview

Studies have shown that people with a driver's license have two and a half times more visits for chronic care and almost two times more visits for regular check-up care than those who do not have a driver's license. Additionally, people with access to affordable public transportation have four more chronic-care visits annually than those who do not. Transportation barriers have also been linked to lower rates of preventive care, compliance with treatment regimens, and accessing emergency care. In 2006, it was estimated that 3.2 million people (4% of the population) either missed a scheduled visit or did not schedule a visit to a healthcare provider because of transportation issues. This estimate increased to 7% for families with an income of less than $50,000 per year.

Urban areas in the United States have tremendously benefited from the vast amounts of healthcare resources available, ranging from ambulatory and air transportation to a choice of medical facility. [Page 1128]Although efficient transportation services in urban areas allow those with an emergent condition to choose from various acute-care facilities, many more individuals fail to receive adequate transportation to even primary healthcare. Urban health departments are using multi-million-dollar government grants to coordinate emergency transportation for thousands of people to receive medical care in the event of a mass casualty; however, more than half of some rural residents cannot find any transportation to receive immediate medical care. Furthermore, if transportation becomes available, many still cannot afford to pay for it.

Inaccessibility

While transportation has certainly eased the suffering of many, it is still an inaccessible resource to many—namely, the elderly, children, minorities, the indigent, and the rural population. The elderly use a variety of transportation methods to access the healthcare system, including driving themselves, depending on someone else, or using public transportation. Due to health problems with aging, the elderly may be unable to access healthcare because of travel burdens.

For children, the lack of transportation may mean missing out on routine medical care such as immunizations and well-child care, in addition to the increased suffering from chronic illness. Because children miss out on routine medical care, they are often transported to emergency rooms when the need for care is urgent—resulting in an increased use of emergency rooms and hospitalizations. These emergency room visits may be prevented with better access to transportation to primary care. As late as 2001, one in five children living in families at or below the poverty level in the United States was unable to access routine medical care due to the lack of transportation. (Though Medicaid recipients are entitled to transportation to receive care, many are unaware of this benefit.) Additionally, almost 50% of families reported that public transportation was not a viable option to travel to medical facilities. In rural areas, this figure was almost 75%.

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