Access to Healthcare and the Critical Role of Transportation Equity
Access to healthcare is one of the fundamental social determinants of upward mobility. Meaning, that those who have reliable access to health care facilities are more likely to move into a higher socio-economic class. However, systemic barriers often prevent this mobility.
Transportation as a Significant Barrier to Care
A study looking at transportation barriers in the Unites States from 1997-2017 found that, “transportation barriers are a significant impediment to health care access, especially for those with lower incomes….” (Wolfe et al, 2020). The scale of this issue is immense; in 2017 alone, 5.8 million people in the United States delayed medical care because they did not have transportation.
This lack of access creates a dangerous cycle:
- The delay of receiving treatment often leads to a worsening of chronic diseases which then become even more expensive to care for.
- The cycle of poverty created through inequitable access to health urgent care, pharmacies, and other healthcare facilities is a significant contributor to life expectancy disparities within even small areas.
- A review published in the Journal of Community Health found that around 25% of lower-income patients have missed or rescheduled their appointments due to lack of transportation.
The Impact on Patient Outcomes
The consequences of transportation inequity extend to medication adherence. The patients who reported issues with transportation also missed filling prescriptions more than twice as often as patients without that same problem. Furthermore, a 2019 survey of low-income patients reported that those who rode the bus to the doctor’s office were twice as likely to miss appointments as patients who drove cars.
Life Expectancy Disparities: The Tulsa Case Study
Life expectancy refers to the average number of years a person is projected to live. The life expectancy disparities in Tulsa, OK have been tracked closely by the Tulsa Health Department and the findings are troubling. The following table illustrates the gap between different neighborhoods in 2015:
| Location (Zip Code) | Average Life Expectancy |
|---|---|
| North Tulsa (74130) | 68.5 years old |
| South Tulsa (74133) | 80.7 years old |
| Total Disparity | 12.3 years |
The correlation between life expectancy and socioeconomic factors is strong, which support the findings that, “individuals carrying the highest burden of disease faced the greatest transportation barriers and were more likely to be older, poorer, less-educated, female, people of color, and people with chronic illnesses or disabilities.” (Wolfe et al, 2020).
The Path Toward Transportation Equity
Equitable access to transportation is one factor in why life expectancy disparities exist in Tulsa, OK and around the world. Tulsa, OK was able to lower the disparity between some zip codes in the past by investing in the development of new medical facilities closer to those North Tulsa neighborhoods. While this progress is worth celebrating, building new services in communities is only a step forward; it doesn’t solve the problem of giving everyone the choice to find the health care services they prefer.
Reliable, affordable, and accessible transportation provides people the freedom to choose the best care possible for them and their families. Whether in health care, education, or job opportunities, advocating for equitable transportation goes beyond mobility, it impacts every area of an individual’s well-being.