Transportation barriers, emergency department use, and mortality risk among us adults

A national health interview survey analysis

Bibliographic Data

ID15366992
AuthorsFangyuan Chen (0000-0001-5148-6280, Tsinghua University), Ryan David Nipp (0000-0002-4577-3248, University of Oklahoma Health Sciences Center), Xuesong Han (0000-0001-7159-7949, American Cancer Society), Zhiyuan Zheng (0000-0003-0220-5360, American Cancer Society), K Robin Yabroff (0000-0003-0644-5572, American Cancer Society), Tianci Wang (0000-0002-6203-2310, Texas Christian University), Changchuan Jiang (0000-0002-7392-4154, Southwestern Medical Center, corresponding author)
Year2025
Volume25
Issue1
Pages3348-3348
Publication date2025-10-06
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC Public Health (JOURNAL)
Journal identifiersISSN: 1471-2458 • E-ISSN: 1471-2458
PublisherBioMed Central (PUBLISHER • GB)
DOI10.1186/s12889-025-24670-4
PMID41053696
OpenAlexW4414861584
LanguageEN
Citations received1
References cited24

To estimate the prevalence of transportation barriers to care among patients with common chronic health conditions and examine associations between transportation barriers with the outcomes of emergency department use and all-cause mortality risk using a large, nationally representative cohort in the United States. We used weighted logistic and Cox regression to assess the association of transportation barriers, ED use and all-cause mortality, in 440,249 US adults aged 18–79 from the 2002–2018 National Health Interview Survey (NHIS) and linked mortality data. Transportation barrier was higher in adults with chronic health conditions (history of hypertension, cardiac diseases, chronic obstructive pulmonary disease (COPD)/asthma, class III obesity, diabetes, and cancer). It was also associated with increased risk of emergency department use (age 18–64: odds ratio (OR) = 1.45, 95% confidence interval (CI):1.41–1.50; age 65+: OR = 1.34, 95%CI:1.26–1.42), and all-cause mortality (age 18–64: hazard ratio (HR) = 1.36, 95%CI:1.24–1.49; age 65+: HR = 1.30, 95%CI:1.15–1.47). These associations also hold in subgroups with all chronic health conditions, except older adults with cancer history. Transportation barriers disproportionally burdened adults with chronic health conditions, which warrant effective screening for and interventions against transportation barriers for individuals with chronic diseases

Biostatistics · Confidence interval · Emergency department · Hazard ratio · Logistic regression · National Health Interview Survey · Odds ratio · Psychological intervention · Public health · Emergency and Acute Care Studies · Health disparities and outcomes · Healthcare Policy and Management · Epidemiology

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