Tag Archives

Archive of posts published in the category: Health
Apr
26

Access to transportation and health care utilization in a rural region. – PubMed

CONTEXT:

Access to transportation to transverse the large distances between residences and health services in rural settings is a necessity. However, little research has examined directly access to transportation in analyses of rural health care utilization.

PURPOSE:

This analysis addresses the association of transportation and health care utilization in a rural region.

METHODS:

Using survey data from a sample of 1,059 households located in 12 western North Carolina counties, this analysis tests the relationship of different transportation measures to health care utilization while adjusting for the effects of personal characteristics, health characteristics, and distance.

FINDINGS:

Those who had a driver’s license had 2.29 times more health care visits for chronic care and 1.92 times more visits for regular checkup care than those who did not. Respondents who had family or friends who could provide transportation had 1.58 times more visits for chronic care than those who did not. While not significant in the multivariate analysis, the small number who used public transportation had 4 more chronic care visits per year than those who did not. Age and lower health status were also associated with increased health care visits. The transportation variables that were significantly associated with health care visits suggest that the underlying conceptual frameworks, the Health Behavior Model and Hagerstrand’s time geography, are useful for understanding transportation behavior.

CONCLUSIONS:

Further research must address the transportation behavior related to health care and the factors that influence this behavior. This information will inform policy alternatives to address geographic barriers to health care in rural communities.

Source Article

Apr
23

Transportation Barriers to Health Care Access

Ahmed et al. [1] N = 413 adults
Urban (Dayton, Ohio), low SES 71 % female, 48 % Black, 42 % Appalachian Door to door survey on barriers to health care access “Difficulty finding transportation” (1) “Hard” or “very hard” time finding transportation (31 %) Arcury et al. [37] N = 1,059 adults
Rural (North Carolina), mixed SES, 662 female, 948 Whites, 112 Blacks Retrospective, comparing transportation barriers and health care utilization “Distance to care for… regular visit… for less serious emergency… for serious emergency” (3)
Has a driver’s license, any household member has a driver’s license, number of vehicles owned in household, days per week spent driving, relative or friend who regularly provides transportation for a family member, knowledge of organizations that provided transportation to health care and use of such transportation (7) Health care utilization associated with having a driver’s license (OR 2.29 more visits) and having a friend or relative who provides transportation (OR 1.58 more visits) Blazer et al. [14] N = 4,162 adults, age 65 +
Rural/Urban North Carolina), mixed SES, 62 % female, 68 % Non-Black (majority White) Retrospective cross-sectional survey (1986/87) analyzed for urban/rural variation of health service use, satisfaction, barriers to care Do you put off or neglect going to the doctor because of “distance or transportation”? (1) No difference between urban and rural residents in health service use; 7.7 % delayed care due to distance or transportation Borders et al. [54] N = 2,097 adults, age 65 +
Rural (West Texas), mixed SES 71 % female, 1949 Non-Hispanic, 148 Hispanic Telephone survey on barriers to health care access “Always/usually get transportation to doctor’s office” (1) Non- Hispanics (96 %) vs. Hispanics (90 %) could usually get transportation to clinic Branch et al. [36] N = 776 adults, age 65 +
Massachusetts, 95 % Medicare, 17 % Medicaid, 61 % privately insured, 64 % female Race not reported Retrospective survey interviews on barriers to health care access “You did not have a way to travel to the doctor” (1) Not having a way to get to the doctor (3 %); travel difficulties associated with lower income, being female, living alone, having less education Call et al. [56]b N = 1,853 Minnesota Health Care Plan adult and parent enrollees
Minnesota, 65 % female adult enrollees, 47 % female parent enrollees, 1,314 Whites, 539 American Indians Mailed survey on barriers to health care access “Difficulties with transportation” (1) American Indians (39 %) vs. Whites (18 %) have difficulties with transportation Canupp et al. [49] N = 163 adults, mean age 26 with spinal cord injuries
Birmingham, Alabama, 25 % had income greater than 25,000 dollars, 14 % female, 63 % white Face to face survey on barriers to follow- up appointments Obstacles for follow-up included distance to travel and availability of transportation (2) Non-compliance with appointments associated with distance to travel (P = 0.004) and availability of transportation (P = 0.033) Crain et al. [15]b N = 1,376 caretakers of
Apr
20

Veterans Transportation Service (VTS) – Health Benefits

Veterans Transportation Service (VTS)

VA recognizes Veterans who are visually impaired, elderly, or immobilized due to disease or disability, and particularly those living in remote and rural areas face challenges traveling to their VA health care appointments. Veterans Transportation Service (VTS) is working to establish Mobility Managers at each local VA facility to help Veterans meet their transportation needs.

VTS has established a network of transportation options for Veterans through joint efforts with VA’s Office of Rural Health and organizations, such as Veterans Service Organizations (VSOs); community transportation providers; federal, state and local government transportation agencies; non-profits and Veterans Transportation Community Living Initiative (VTCLI) grantees.

Department of Veterans Affairs Access Van

How to Apply

Veterans who are eligible for VA health care benefits and have a VA-authorized appointment are eligible for transportation through the VTS program based on the availability and guidelines in place at their local facility. Each local VA authorized facility has ridership guidelines based on their capabilities.

VTS Locations

Participating VA medical centers (VAMCs) offer VTS to assist Veterans in accessing transportation to VA medical facilities or authorized non-VA appointments to receive the care they have earned. Find a VTS office near you.

Source Article

Apr
16

Traveling towards disease: transportation barriers to health care access. – PubMed

Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

Source Article

Apr
15

Bicycle Health & Fitness – Cycling to work

Considered before as a career for women, a lot of males have now realized the numerous positive reasons why it…

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Different women may have different side effects or symptoms during menopause. That is because the level of estrogen used by…

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In a world constantly seeking variety and entertainment, hitting the traditional gym where you spend hours on a boring treadmill…

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You may be looking to take care of your skin. There are many ways you can do this, with the…

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You have tried everything. All the fads and trends on how to lose weight but no matter what you do,…

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We need to step under the sun at some point in the day. While it is great for us, it…

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There are many people who ought to look for the more difficult and tedious ways of maintaining physical fitness while…

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Like every place that has a certain decorum, a gym is no different; you must dress appropriately for that particular…

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Keeping your health in check is important. Always find time to have regular check-up in between your busy schedule. Also,…

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I used to hate exercising, but I knew I had to do it to maintain my health. It was the…

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Source Article

Apr
9

In a Global Health Emergency, the Bicycle Shines

As the coronavirus crisis forces changes in transportation, some cities are building bike lanes and protecting cycling shops. Here’s why that makes sense.

Speaking in Parliament in London earlier this year, Chris Boardman, the former Olympian cyclist and the walking and cycling commissioner of Manchester, said: “Pick a crisis, and you’ll probably find cycling is a solution.”


He was talking about climate, health and air pollution, but he also might as well have been talking about coronavirus.


As Covid-19 rages, almost half of the world’s population is under some form of restricted movement. In a bid to slow the spread of coronavirus, people must stay home, aside from strictly limited essential trips for food and medicine and a daily outing for exercise. We all need to comply with restrictions to bring this life-threatening virus under control. I believe the best way to keep a safe distance from others when we do move is by walking, and cycling.


Many experts view cycling as a safe way to avoid crowded public transportation systems — and the citizens in a number of world cities appear to agree. In New York, cycling spiked by 52% over the city’s bridges after social-distancing protocols were put in place. In Chicago, bikeshare use doubled in early March. In Dublin and London, advocates are offering support to new riders who are taking to the streets in droves.


Cycling can help communities in “food deserts” access shops that are farther than a walk away. It speeds the delivery of food and medicine for households without a car, or those who are quarantined at home. And it helps people avoid car trips, cutting air pollution and freeing up public transit for those who absolutely need it.


To protect people doing essential trips — including medical staff, who need to get to work — networks of emergency cycleways could be built quickly and cheaply, using easy-to-install temporary bollards and wands, as the city of Seville once did. Low-traffic neighborhoods can connect those routes, stopping shortcutting drivers using residential streets with low-tech planters and bollards, while allowing residents in and out by bike. During the crisis, and as society recovers, this network could keep residents active and healthy, where local restrictions permit. It would also be free to use — more valuable than ever amid a global economic disruption. Once we reach the other side, communities could decide whether to keep the new infrastructure or not.


This is hardly the first time that cities have used cycling as an emergency transportation solution. The usefulness of bicycles in disaster recovery was demonstrated anew after severe earthquakes in Mexico City in 2017 and Tokyo in 2011. A broader global crisis — the 1973 OPEC oil embargo — offered another opportunity for bicycles to step up. That shock to the gasoline supply dealt a severe blow to daily life in the U.S. and many car-dependent Western European nations. But in

Apr
3

Transportation and Health

Three female pedestrians crossing a street.

Transportation decisions that take place upstream affect our lives downstream. We all use various ways to get to work or school, to access healthy foods and to do countless other things every day. Yet poor transportation decisions can harm health and are not always fair across all communities.

For example, communities near a highway or major roadway are often low-income and communities of color. Living near a highway or major roadway increases a person’s exposure to traffic-related air pollution. Traffic-related air pollution is linked to respiratory conditions like wheezing and decreased lung functioning and also cardiovascular disease. Long-term exposure to traffic-related air pollution is linked to childhood asthma.

APHA speaks out for transportation policy that improves, rather than hinders, public health. We believe in working with the transportation sector to create equitable and healthy transportation policies. 

Check out our two latest Transportation and Health Stories from the Field showing how transportation and health agencies collaborate together to support active living for everyone:

  • Planning with a Public Health Focus- Connecting the Dots in the East Central Region of Wisconsin (PDF) — Learn how the East Central Wisconsin Regional Planning Commission works with public health departments and nonprofit partners to identify shared values to support active living and integrate public health into transportation plans. 
  • Minnesota Health and Transportation- Partners for Change (PDF) — Learn how Minnesota Department of Transportation and Department of Health have partnered together over the years to advance health equity through such initiatives as health impact assessments and Minnesota Walks, one of the first statewide pedestrian planning frameworks in the country that recognizes health and walking as transportation planning priorities. 

Building Healthy and Prosperous Communities: How Metro Areas are Building More and Better Bicycling and Walking Projects

Over the last two years, Transportation for America, in conjunction with the APHA, worked with metropolitan planning organizations across the country to collect and document stories about how they are planning, funding, and building more and better walking and bicycling projects. Check out the guidebook Building Healthy and Prosperous Communities: How Metro Areas are Building More and Better Bicycling and Walking Projects.

Working with Metropolitan Planning Organizations

Ever wondered what a Metropolitan Planning Organization was and how to work with one? Check out our latest guide (PDF) outlining the core responsibilities of an MPO and how to partner with them to advance healthy communities. 

If you are interested in learning more about past work highlighting MPO efforts, check out this set of case studies and policy paper authored by Transportation for America, with support from APHA.

Transportation and Health Tool Case Studies

APHA recently released five case studies that provide valuable insight into opportunities to advance health on both state and regional levels. The case studies feature organizations using the Transportation and Health Tool indicators to:

Want to learn more about the Transportation and Health Tool? Read an article in the Journal of Transport & Health about the Transportation and Health Tool. You can also listen to the Incorporating Health