Citation

Wolfe MK, McDonald NC, Holmes GM. Am. J. Public Health 2020; ePub(ePub): ePub.

Affiliation

Mary K. Wolfe and Noreen C. McDonald are with the Department of City and Regional Planning, University of North Carolina at Chapel Hill. G. Mark Holmes is with the Department of Health Policy and Management and North Carolina Rural Health Research and Policy Analysis Center, University of North Carolina at Chapel Hill.

Copyright

(Copyright © 2020, American Public Health Association)

DOI

10.2105/AJPH.2020.305579

PMID

32298170

Abstract

Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations.Methods. We used data from the National Health Interview Survey (1997-2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017.Results. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics.Conclusions. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology. (Am J Public Health. Published online ahead of print April 16, 2020: e1-e8. doi:10.2105/AJPH.2020.305579).

Language: en