Travel for medical or dental care by race/ethnicity and rurality in the U.S.: Findings from the 2001, 2009 and 2017 National Household Travel Surveys

Marvellous Akinlotan; Nima Khodakarami; Kristin Primm; Jane Bolin; Alva O Ferdinand

doi:10.1016/j.pmedr.2023.102297

Travel for medical or dental care by race/ethnicity and rurality in the U.S.: Findings from the 2001, 2009 and 2017 National Household Travel Surveys

Prev Med Rep. 2023 Jun 23:35:102297. doi: 10.1016/j.pmedr.2023.102297. eCollection 2023 Oct.

Authors

Marvellous Akinlotan¹, Nima Khodakarami², Kristin Primm³, Jane Bolin^{1

4

5}, Alva O Ferdinand^{1

5}

Affiliations

¹ Southwest Rural Health Research Center, Texas A&M School of Public Health, USA.
² Department of Health Policy & Administration, Penn State Beaver, USA.
³ Department of Epidemiology, The University of Texas MD Anderson Cancer Center, USA.
⁴ Texas A&M College of Nursing, USA.
⁵ Department of Health Policy & Management, Texas A&M School of Public Health, USA.

Abstract

The travel burden for medical or dental care is a well-documented barrier to healthcare access, particularly in rural areas. There is limited research providing national estimates of the travel trends for medical/dental care, particularly among racial/ethnic groups, and among rural and urban populations. We analyzed data from the 2001, 2009, and 2017 National Household Travel Surveys. Main outcomes were the average travel distance (in miles), average travel time (in minutes), and travel burden, characterized as the percentage of trips lasting ≥ 30 miles or minutes for medical/dental care. We used ordinary least squares and multivariable logistic regressions to examine trends in the travel time/distance and travel burden, controlling for socio-demographic and travel dynamics. Among rural residents, the average travel distance for medical/dental care increased by 17.8% between 2001 and 2017, while no increase was observed among urban residents. Thirty-six percent of trips among rural residents lasted ≥ 30 minutes in 2001 but increased to 47.4% in 2017. Logistic regression estimates show that though Blacks experienced higher odds of a travel time burden compared to Whites, the burden lessened over time. In 2017, urban Blacks (OR = 0.41, 95% C.I. = 0.26,0.66), and rural Blacks (OR = 0.16, 95% C.I. = 0.05,0.55) were less likely to spend ≥ 30 minutes traveling for medical/dental care compared to Whites, using the year 2001 as the baseline. The travel distance and time for medical/dental care have increased in rural areas. However, the travel burden among rural and urban Black residents has decreased. Continuing to alleviate excess burdens of transportation may be beneficial.

Keywords: African American; Hispanic or Latino; Rural health services; Rural population; Transportation; Urban population.