Walking, biking, driving … it can be easy to take for granted how we get around. I was reminded of that a few weeks ago, when a broken right foot led to doctor’s orders for me to limit walking and to stop driving for six weeks. Fortunately I’ve received help getting where I need to go from a supportive family, generous friends, and RideKC.
And my situation is temporary – after six weeks I should be free to come and go as I please once again. Others aren’t so fortunate.
At Health Forward Foundation, we know that too many people don’t have that luxury. Transportation barriers disrupt many everyday activities, including accessing health care.
In our country an estimated 3.6 million people don’t get medical care because they experience transportation barriers. Some groups of people are affected more than others.
About 4 percent of all children, and 9 percent of children in families with incomes less than $50,000, miss a health care appointment once a year because transportation is not available. When older adults are asked about barriers to care, transportation is the third most frequently mentioned obstacle.
What do transportation barriers look like? Costs associated with driving might lead patients to limit trips to a doctor’s office. For people who depend on public transit, bus routes and schedules can lengthen the time it takes to get from one place to another, especially when they are moving between cities and towns and in suburban areas. A long ride can mean missing work, which is especially troublesome for those who do not have paid time off.
Even my temporary experience using KC’s bus system provides an example of the limitations faced by those who rely on public transit. My commute lengthened to accommodate travel to and from the nearest bus stop (just under 5 miles from my house) and wait time for buses that were not always on schedule (sometimes as much as 20 minutes behind). Buses on my route run every 30 minutes and only at the start and end of the business day, reducing the flexibility I had when I could set my own driving schedule. Lack of a bus shelter at the bus stop near my office made the weather forecast and spring rainstorms seem more significant.
That was for a suburb to city commute. Where distances are longer, such as in rural areas, issues of transportation cost and public transit access can be exacerbated.
Right in our region, Community Health Needs Assessments (CHNAs) – which document local priority health – often highlight the interplay between transportation and health. In the CHNAs from Children’s Mercy, Truman Medical Center, and Olathe Medical Center, as well as health departments in Jackson and Johnson counties, transportation was identified as having a major impact on access to health care. Special concern was raised about the limits of public transportation for people without cars. It was also noted that transportation can play a role in the things we do to stay well. For example, the Jackson County CHNA highlights that poor access to transportation can limit a person’s ability to buy healthy food.
These circumstances can influence health care utilization and cost. When transportation barriers get in the way, people may miss or postpone health care appointments. The result can be delays in needed care, disrupted patient-provider relationships, and increased emergency department visits. Patients are less likely to fill prescriptions if they experience transportation barriers.
Health Forward has been and continues to be interested in better understanding what impacts the health of the underserved in the communities we serve. There is more to learn about how transportation, or lack thereof, impacts the wellness of those in our community. This is a complex issue. Health Forward values the efforts made by our community partners toward finding mobility solutions for those most in need of quality health care. They have a right to receive health care, regardless of circumstance.
Many thanks to my colleague Shannon Morris for his invaluable help on this blog post.