Predictors of transportation-related barriers to healthcare access in a North American suburb

Aim

To identify predictors of transportation-related barriers to healthcare access in a North American suburb.

Subject and methods

Data from the 2022 Scarborough Survey were used, comprising n = 528 adults living in Scarborough, which is a subu

Results

Of the sampled individuals, 34.5% experienced the outcome. In the multivariable model, younger age (RR = 3.03), disability (RR = 2.60), poor mental health (RR = 1.70) and reliance on public transit (RR = 2.09) were associated with greater risk of experiencing the outcome. Full-time employment, reliance on active travel and reliance on others for transportation were specifically associated with greater risk of experiencing a transportation-related barrier to vaccination.

Conclusion

In suburban areas such as Scarborough, transportation-related barriers to healthcare access have a disproportionate impact on groups defined by important demographic, health and transportation-related characteristics. These results corroborate that transportation is an important determinant of health in suburban areas, the absence of which may exacerbate existing inequities among the most vulnerable individuals in a given population.

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Key Words

• Health care quality, access, and evaluation
• Healthcare disparities
• Suburban health
• Suburban population
• Transportation

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Affiliation(s)

Joonsoo S. Lyeo Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
Ignacio Tiznado-Aitken Department of Human Geography, University of Toronto Scarborough, Toronto, Ontario Canada
Steven Farber Department of Human Geography, University of Toronto Scarborough, Toronto, Ontario Canada
Hilary K. Brown Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario Canada
Nicholas Spence Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario Canada Department of Sociology, University of Toronto, Toronto, Ontario Canada

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Fair transport policies for older people: accessibility and affordability of public transport in Santiago, Chile

In this paper, we test how different public transport policy scenarios score in terms of fairness for a specific population group, considering a more complex representation of mobility-related inequalities and the policy implications of transport justice. To do so, we assess potential accessibility to public transport in Santiago de Chile under different policy scenarios, focusing on older people as a group whose demographic and socioeconomic conditions can determine different forms of disadvantage. We compare alternative accessibility policies based on the expansion of the Metro infrastructure network or on reduced public transport fares, considering the interaction between the spatial availability and the affordability of public transport. Results show that subsidized fares for public transport services are more beneficial to expand the accessibility of older people, especially those with lower incomes, while the expansion of the Metro network benefits mainly middle- and high-income older people. The proposed analysis is a first step towards a more detailed, place-based reading of mobility-related inequalities, aimed at assessing alternative policy measures.

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Supplementary Information

The online version contains supplementary material available at 10.1007/s11116-022-10344-2.