TY  - JOUR
PY  - 2023//
TI  - A driver in health outcomes: developing discrete categories of transportation insecurity
JO  - American journal of epidemiology
A1  - McDonald-Lopez, Karina
A1  - Murphy, Alexandra K.
A1  - Gould-Werth, Alix
A1  - Griffin, Jamie
A1  - Bader, Michael D. M.
A1  - Kovski, Nicole
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - Research suggests that transportation is an important social determinant of health because the ability to get around is consequential for accessing healthcare and nutritious food and for making social connections. We use an inductive mixed-methods approach and a quantitative k-means clustering approach to identify five categories of transportation insecurity using the validated 16-item Transportation Security Index. The resulting five-category measure distinguishes among respondents with qualitatively different experiences of transportation insecurity. Analyzing data from 2018 that is representative of the U.S. adult population aged 25 and older, we demonstrate a non-parametric association between transportation insecurity and two different health measures. Self-rated health had a threshold relationship between self-rated health and any level of transportation insecurity. High transportation insecurity had a very strong relationship to depressive symptoms. The categorical TSI will be useful for clinicians who wish to screen for transportation barriers to care. It will also facilitate research investigating the influence of transportation insecurity on health outcomes and provide the basis for interventions to address health disparities.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9262
UR  - http://dx.doi.org/10.1093/aje/kwad145
ID  - ref1
ER  -