SDOH, Transportation Access a Problem for 5.7% of Patients

January 12, 2024 - Transportation access continues to be a leading social determinant of health, with new CDC data showing it affected 5.7 percent of adults over the course of 12 months.

The report, which used 2022 data, also showed that women were more likely than men to face transportation access barriers, with 6.1 percent and 5.3 percent reporting as much, respectively.

Transportation access has an impact on numerous functions of daily living, the CDC researchers acknowledged. Without regular access to transportation, it can be hard to get to work, attend doctor’s appointments, and even drive to get the essentials, like groceries.

“Previous research suggests that a lack of transportation, especially among adults who are older, uninsured, and have lower incomes, leads to reduced access to health care, which may then lead to adverse health outcomes,” CDC added.

This latest report looked at self-reported transportation access, which CDC defined as “a lack of reliable transportation [that] kept [respondents] from medical appointments, meetings, work, or from getting things [they] needed for daily living.”

Transportation is still a salient SDOH, the report revealed. And in addition to the broad figures about how many people experience transportation barriers, the CDC data dug into who, in particular, was mostly to lack transportation.

Younger adults rather than older adults, for example, were more likely to face challenges related to transportation access, with 7 percent of 18-34-year-olds reporting problems compared to 4.5 percent of those over age 65. Odds of transportation-related barriers decreased with age, the CDC researchers said.

Moreover, racial disparities persisted, with American Indian/Alaska Native adults being the most likely to report a lack of reliable transportation. Of those respondents, 17.1 percent said they faced barriers in the previous 12 months.

That compares to 9.2 percent of Black respondents, 7.6 percent of other or multiple-race respondents, 6.9 percent of Hispanic respondents, 4.8 percent of White respondents, and 3.6 percent of Asian respondents who said the same.

Income and educational attainment, too, were linked with transportation barriers, with higher-income people with greater educational attainment being less likely to report transportation barriers. For example, 15.8 percent of adults with family incomes less than 100 percent of the federal poverty level reported transportation challenges, compared to 2.9 percent of adults with family incomes of 400 percent of the federal poverty level or greater.

Relatedly, greater educational attainment—a college degree or higher—was linked with fewer transportation barriers, with 3.8 percent of these respondents reporting such. That’s compared to 9.7 percent of respondents with less than a high school diploma/GED who said the same. This is unsurprising, considering the link between educational attainment and income.

Disparities likewise emerged when breaking down figures by region. The Northeast had above-average access to transportation, meaning it was typically easier for respondents living in this area to access transportation. By comparison, transportation access in the Midwest was below national average.

These findings are notable considering the impact transportation access can have on health and well-being. As CDC noted in the study’s introduction, transportation impacts patient access to medical care. A patient without reliable transportation may not make it to a wellness check or follow-up appointment.

But transportation access is a key SDOH for more than just direct patient interactions with the healthcare industry. Poor access to transportation can impact how well an individual can obtain certain goods, like nutritious groceries, or attend meetings or social gatherings, adversely affecting both food security and social isolation, two other SDOH.

These CDC findings give healthcare policymakers a picture of how common the transportation problem is and a breakdown of the key populations affected by transportation barriers.