Transportation + Social Determinants of Health
Good health and well-being are the result of myriad personal (biological, genetic), social, economic, policy, and environmental factors as well as health care services themselves. These wide-ranging group of factors are often referred to as the determinants of health. Those factors in the social realm, known as “social determinants of health” (SDOHs), are defined as the environments in which people are “born, live, learn, work, play, worship, and age.” These factors are known to affect a wide range of health, functioning, and quality-of-life outcomes and risks.
Transportation's role in social determinants of health
Not only is transportation itself a critical social determinant of health, but it also impacts almost every other social determinant by either providing or hindering access to those services or destinations. A 2019 survey by Kaiser Permanente showed that:
- Americans view social needs, such as housing and transportation, as equally important to their health as medical care.
- The vast majority of Americans want their medical providers to ask about social needs.
- Those experiencing unmet social needs were twice as likely to rate their health as fair or poor compared to those who did not.
- Social needs are predictors of physical and mental health.
Given the complexity of what influences our health, there is a growing recognition that no single entity alone can tackle the wide gamut of social conditions that affect health and well-being. Improving health outcomes in the U.S. will require new partnerships that break down the silos among health care, public health, social services agencies, and the mobility sector to better address the varied and dynamic factors that affect our health.
To date, however, addressing overlapping and cross-sector factors has proven challenging as health care, public health, human services, and transportation have historically operated within separate and distinct divisions: health care focuses on clinical care, public health targets broader population-level health and disease, and human services provide specific resources and services such as education, housing and transportation. The differing goals of each sector create unique challenges in developing programs and policies that span them. For this reason, it is critical for transportation and mobility professionals to understand not only the impact of their work on individual and community health, but also the value and potential that partnerships could provide to the health and well-being of your community.
For further investigation . . .
Healthy, Equitable Transportation Policy: Recommendations and Research
This edited volume, published by PolicyLink and Prevention Institute, provides in-depth information on the intersection of transportation, equity and health.
Prevalence of Screening for Food Insecurity, Housing Instability, Utility Needs, Transportation Needs, and Interpersonal Violence by US Physician Practices and Hospitals
This study’s findings suggest that few US physician practices and hospitals screen patients for all 5 key social needs associated with health outcomes. Practices that serve disadvantaged patients report higher screening rates.
The following pages take a deeper look at the issues surrounding public health and transportation. On these pages, you will find deeper explanations on the factors that impact social determinants, as well as more resources to help grow your understanding.
Transportation Barriers to Health Care in the United States: Findings From the National Health Survey
This American Journal of Public Health article quantifies the number of people in the US who delay medical care annually
The Hidden Risk of Cutting Medicaid NEMT: An Examination of Transportation Service Interdependency at the Community Level
This report unpacks the interdependency between the provision of Medicaid NEMT and local public transportation. It uses case studies of
This Research in Progress Webinar discusses several low-cost ways of improving transportation opportunities for low-income urban diabetic patients, including providing
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation’s Health
Health care systems are paying increased attention to social factors, such as access to stable housing, reliable transportation, and nutritious food.