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

Joonsoo S Lyeo; Ignacio Tiznado-Aitken; Steven Farber; Hilary K Brown; Nicholas Spence

doi:10.1007/s10389-023-01916-2

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

Z Gesundh Wiss. 2023 Apr 21:1-12. doi: 10.1007/s10389-023-01916-2. Online ahead of print.

Authors

Joonsoo S Lyeo¹, Ignacio Tiznado-Aitken², Steven Farber², Hilary K Brown^{1

3}, Nicholas Spence^{3

4}

Affiliations

¹ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada.
² Department of Human Geography, University of Toronto Scarborough, Toronto, Ontario Canada.
³ Department of Health & Society, University of Toronto Scarborough, Toronto, Ontario Canada.
⁴ Department of Sociology, University of Toronto, Toronto, Ontario Canada.

Abstract

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<rb of Toronto, Canada, recruited through iterative sampling. Log binomial regression models identified demographic, socioeconomic, health and transportation predictors of a composite of: (1) delaying a primary care appointment, (2) missing a primary care appointment or (3) postponing or declining a vaccination due to transportation issues.

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.

Keywords: Health care quality, access, and evaluation; Healthcare disparities; Suburban health; Suburban population; Transportation.

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