For people living in rural areas, access to transportation can have a major impact on personal health.
According to the National Conference of State Legislatures, about 3.6 million Americans don’t receive the medical care they need because they can’t get to their doctor’s appointments. Some can’t afford a personal vehicle, and public transportation often does not serve rural areas. Taxis and other ride-share services can be expensive for long distance trips.
Transportation issues can prove especially difficult for patients with chronic medical conditions, such as diabetes, that are best treated with routine care. Additionally, women who are pregnant benefit greatly from pre-natal care, which requires frequent visits to an OB/GYN. Emergency health situations, such as heart attacks or severe injuries, can be fatal without prompt medical care.
The Rural Health Information Hub, an online clearinghouse for rural health issues funded by the Federal Office of Rural Health Policy, states that transportation is an “important social determinant of rural health issues.” Furthermore, access to reliable transportation is vital for vulnerable populations – such as people who are elderly, families and individuals with low incomes, and people with disabilities – to maintain good health. Without reliable transportation, these populations lose the ability to buy healthy food, benefit from regular and coordinated healthcare, and live independently in their communities.
Agencies and groups across the United States recognize the growing transportation issues in rural areas and are implementing programs to solve the problem. Here are some of them.
Small Town Public Transportation
Tupelo, Mississippi, which has a population of about 36,000 and a high unemployment rate, has long talked about implementing a public transportation system to help people get to jobs. In its absence, however, one private company, mental health service provider Lifecore Health Group, started a transportation system for clients that has grown into a community-wide public transportation program thanks to additional state funding.
Local officials say that a fixed-route public transportation system in the Tupelo area will not reach all residents. However, they are working with Toyota North America and Lifecore’s dial-a-ride service to come up with ideas for a more flexible system that would allow residents to call for rides to and from stops near main public transportation routes.
If the Tupelo city council approves the plan in 2018, leaders in the public transportation movement say they’d like to begin linking with other regional transportation programs.
Federally-Funded Van Service
One private transportation service is using federal funds to offer cheap on-call rides to residents in central Nebraska.
RYDE Transit operates an about 36 small buses and minivans Monday through Friday in seven counties. Riders can call for pick-up, and rides cost $1 per boarding. The company requests the riders schedule trips 24 hours in advance, but it does provide same-day rides in Lexington, Nebraska, a city of about 10,000 in its service area. Some RYDE vehicles are equipped to transport wheelchairs and all are accessible to people who have disabilities.
Most of the rides in Lexington, where RYDE averages 1,000 trips a month, are for medical appointments, Charles McGraw, transportation director for RYDE, told online local news provider Lexch.com.
“I don’t know what I would do without it,” Georgia Ashmore of Lexington told Lexch.com. “I don’t have a car.”
RYDE offers scheduled longer trips, such as the 45-minute drive from Lexington to Kearney, for $4 one-way. McGraw said that RYDE will be expanding its long-distance routes, and transportation officials are also considering a statewide van pool and offering rides at night.
Healthcare on Wheels
In some rural communities, medical professionals are reaching patients by bringing healthcare to them. A study of mobile health care published in 2014 in the American Journal of Managed Care noted that there were 1,500 mobile healthcare units in the United States that saw about 5 million visit each year. Researchers found that mobile healthcare units operate in all states, Washington, D.C., and Puerto Rico, and that each clinic saw an average of about 3,100 visits a year.
Mobile clinic patients tended to live in areas that have the least access to healthcare, the study noted. Medical professionals focus on reaching people who are homeless or displaced, migrant workers, immigrants, people with racial and ethnic minority backgrounds, and adults and children without insurance. The study found that mobile clinics tend to customize their services to fit their communities, focusing on everything from pediatric asthma to dental care. In addition to primary care services, clinics also provide mental health services, mammography, and many specialty services.
Mobile clinics offer considerable benefits beyond cost savings, the study found. Bringing healthcare to underserved communities eliminates transportation issues, appointment scheduling, and other administrative obstacles that can limit access to healthcare. Mobile clinic healthcare providers also tend to build trusting relationships with people in the communities they serve, which can result in better health outcomes for patients.
The study concluded that mobile clinics are important to providing low-cost healthcare to vulnerable populations and revealed the need for increased services and coverage as well as more partnerships between mobile units and health systems and hospitals.