Transportation Barriers to Health Care in the United States

Findings From the National Health Interview Survey, 1997–2017

Bibliographic Data

ID11025635
AuthorsMary K Wolfe (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 at the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.), Mary Wolfe (0000-0001-6043-1433, University of North Carolina at Chapel Hill), Noreen Mcdonald (0000-0002-4854-7035, University of North Carolina at Chapel Hill), Noreen C McDonald (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 at the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.), George M Holmes (0000-0002-6169-7847, University of North Carolina at Chapel Hill)
Year2020
Volume110
Issue6
Pages815-822
Publication date2020-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2020.305579
PMID32298170
OpenAlexW3016969438
LanguageEN
Citations received66
References cited30

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

Environmental health · Health care · Logistic regression · Medicaid · Multivariate analysis · National Health Interview Survey · Odds · Political science · Population · Poverty · Public health · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology