By Katie Jurenka, TransPro Senior Project Analyst

Communities across the country understand the important link between public transit service and health. Surveys conducted by TransPro, show that respondents consistently chose access to medical facilities as one of the most important way a transit agency provides great value to their community.

The following is a brief overview of public transit and healthcare access, including transit’s role in improving health outcomes, supporting the workforce, and the importance of selecting the right destinations and methods to meaningfully measure healthcare access.

Why does healthcare access matter?

Lack of transportation is a major barrier to healthcare access, leading to worse health outcomes. Only 18% of patients are transported via Emergency Medical Services (EMS) to emergency departments, leaving the remaining 82% of patients to rely on private transportation.[1]

Research demonstrates that patients without reliable access to transportation miss or reschedule appointments, miss or delay seeking care and/or taking important medication. Missed or delayed care leads to poorer health outcomes, including worsening chronic health conditions.[2] Missed appointments also financially burden healthcare providers by reducing efficiency and leading to lost revenue.[3]

Public transit can improve outcomes for people without access to a vehicle. 21% of adults without access to a vehicle who live in areas with low transit service delay important medical care because of difficulty getting to appointments, compared to 9% of adults without access to vehicles who live in neighborhoods with high access to public transit.[1]

Beyond patients, access to healthcare facilities is crucial for healthcare workers.

Hospitals are among the largest employers and major economic drivers in most metropolitan areas in the United States. Additionally, healthcare workers take transit at a higher rate compared to all workers in the US.^[1] Reliable transit access to healthcare facilities can help attract and retain employees.

What healthcare destinations are important to consider?

While hospitals are the largest healthcare destinations, patients are more likely to interact with pharmacies and urgent care centers on a more regular basis. The following facilities each play a role in the healthcare system:

• Hospitals are the largest healthcare destination. They include emergency departments, specialists and outpatient clinics, and are typically among the largest employers in the area.
• Freestanding emergency departments (FSEDs) have increased significantly in the United States in recent years. They include satellite emergency departments affiliated with a larger hospital or private emergency departments not associated with a hospital.^[2]
• Urgent care centers are walk-in clinics for patients who require timely but not emergency care.^[3]
• Pharmacies are an important part of healthcare service because they provide prescription, over-the-counter medications and vaccinations.^[4]

How do we measure public transit access to healthcare?

The following methodologies represent just a few of the many ways to measure geographic access to healthcare using public transit:

• Single origin: measures the number of people and workers within a single destination, like a major hospital, within a travel time on transit.
• Weighted average access: measures the average number of destinations (hospitals, pharmacies, etc.) a resident in the region can access within a travel time.
• Dual access: measures the time required to access a given number of destinations, e.g. travel time to access the nearest 3 pharmacies.