Greetings TRB Subcommittee Friends,
As you may know, the TRB health and transportation subcommittee developed a newsletter as a way to stay up to date. See the latest edition: http://www.trbhealth.org/newsletter/december-2013.
We're now looking for content for the next edition to be released in April.
Send any pertinent updates related to health and transportation (e.g., new reports, new research, upcoming conferences or events) for consideration via email by Monday, March 25th to me (eloisa.raynault(a)apha.org).
A friendly reminder: please do not 'reply all' to this message.
Thank you,
Eloisa
Apparently the attachment was stripped off. If you want to search for it, the report is called 'Making the connections: final report on transport and social exclusion'
>From the Social Exclusion Unit
(the URL is odd)
Jenny
-----Original Message-----
From: h+t--friends-bounces(a)chrispy.net [mailto:h+t--friends-bounces@chrispy.net] On Behalf Of h+t--friends-request(a)chrispy.net
Sent: 06 March 2014 18:00
To: h+t--friends(a)chrispy.net
Subject: H+T--Friends Digest, Vol 35, Issue 5
Today's Topics:
1. Re: Access to Health Care (Mindell, Jenny)
----------------------------------------------------------------------
Message: 1
Date: Wed, 5 Mar 2014 12:26:00 +0000
From: "Mindell, Jenny" <j.mindell(a)ucl.ac.uk>
Subject: Re: [H+T--Friends] Access to Health Care
To: "h+t--friends(a)chrispy.net" <h+t--friends(a)chrispy.net>
Message-ID:
<76bba635a4724d59a08cc77661b904e0(a)AM3PR01MB116.eurprd01.prod.exchangelabs.com>
Content-Type: text/plain; charset="utf-8"
A report from the UK attached. See pp111 onwards, as well as the summary at the beginning (e.g. Access to healthcare: 31 per cent of people without a car have difficulties travelling to their local hospital, compared to 17 per cent of people with a car. Over 1.4 million people say they have missed, turned down, or chosen not to seek medical help over the last 12 months because of transport problems.)
Regards,
Jenny
Dr Jennifer Mindell
Clinical senior lecturer
Health and Social Surveys Research Group Research Department of Epidemiology and Public Health UCL
1-19 Torrington Place
London WC1E 6BT
Tel. 020 7679 1269 (Internal x41269)
Survey doctor: 07770-537238
Fax 020 7813 0242
Email: j.mindell(a)ucl.ac.uk<mailto:j.mindell@ucl.ac.uk>
Web: IRIS web page<http://iris.ucl.ac.uk/research/personal/index?upi=JMIND63>
Journal of Transport and Health: www.elsevier.com/locate/jth<http://www.elsevier.com/locate/jth>
-----Original Message-----
Today's Topics:
1. Access to Health Care (Ed Christopher)
2. Re: Access to Health Care (Rajiv Bhatia)
3. Re: Access to Health Care (denita Jones)
4. Re: Access to Health Care (Rajiv Bhatia)
----------------------------------------------------------------------
Message: 1
Date: Fri, 28 Feb 2014 14:43:16 -0600
From: Ed Christopher <edc(a)berwyned.com<mailto:edc@berwyned.com>>
Subject: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <5310F4E4.9060008(a)berwyned.com<mailto:5310F4E4.9060008@berwyned.com>>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed
I got asked a question today, from a transportation perspective, about access to health care and health facilities. As I started to hunt around on the web I thought I would throw it out to our Listserve. Does anyone know of any research, literature or other articles that they could pass along dealing with access to health care services?
Thanks
--
Ed Christopher
------------------------------
Message: 2
Date: Fri, 28 Feb 2014 13:13:39 -0800
From: Rajiv Bhatia <rb6419(a)gmail.com<mailto:rb6419@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com<mailto:73BF7334-5E7C-4BC7-8B00-1C6139B8B486@gmail.com>>
Content-Type: text/plain; charset=us-ascii
There is limited information on this topic. I did a review of this and other EJ impacts for EPA a few years ago.
A few studies have looked at transport access to facilities and their association to health outcomes. Most studies treated the "exposure variable" as auto ownership. Net conclusion is that auto owners have better access to health facilities. THere is a very limited association to health outcomes.
I would not take this as a null result -- just one that has been understudied.
Rajiv
------------------------------
Message: 3
Date: Fri, 28 Feb 2014 15:12:18 -0600
From: denita Jones <denita944(a)gmail.com<mailto:denita944@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID:
<CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=5vJ7_jHgdNnmA(a)mail.gmail.com<mailto:CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=5vJ7_jHgdNnmA@mail.gmail.com>>
Content-Type: text/plain; charset="iso-8859-1"
Im actually presenting research in that area in DC next month. I'm not in a
position now to give the names of articles (im driving) But I can send them
to you and suggest sites.
------------------------------
Message: 4
Date: Fri, 28 Feb 2014 18:58:16 -0800
From: Rajiv Bhatia <rb6419(a)gmail.com<mailto:rb6419@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54(a)gmail.com<mailto:B6368ACB-B234-45D2-87FB-80F7D05E9F54@gmail.com>>
Content-Type: text/plain; charset="us-ascii"
Ed
These are the studies I found in a 2009 review -- i'm sure there are new ones.
1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers to healthcare access in a non-elderly urban poor American population. Health and Social Care in the Community. 2001; 9:445-453.
2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR. Transportation barriers to accessing health care for urban children. Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer GE. Practical barriers to timely primary care access: impact on adult use of emergency department services. Archives in Internal Medicine. 2008; 168:1705-1710.
4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to transportation and health care utilization in a rural region. Journal of Rural Health. 2005; 21:31-38.
End of H+T--Friends Digest, Vol 35, Issue 1
*******************************************
A report from the UK attached. See pp111 onwards, as well as the summary at the beginning (e.g. Access to healthcare: 31 per cent of people without a car have difficulties travelling to their local hospital, compared to 17 per cent of people with a car. Over 1.4 million people say they have missed, turned down, or chosen not to seek medical help over the last 12 months because of transport problems.)
Regards,
Jenny
Dr Jennifer Mindell
Clinical senior lecturer
Health and Social Surveys Research Group
Research Department of Epidemiology and Public Health
UCL
1-19 Torrington Place
London WC1E 6BT
Tel. 020 7679 1269 (Internal x41269)
Survey doctor: 07770-537238
Fax 020 7813 0242
Email: j.mindell(a)ucl.ac.uk<mailto:j.mindell@ucl.ac.uk>
Web: IRIS web page<http://iris.ucl.ac.uk/research/personal/index?upi=JMIND63>
Journal of Transport and Health: www.elsevier.com/locate/jth<http://www.elsevier.com/locate/jth>
-----Original Message-----
Today's Topics:
1. Access to Health Care (Ed Christopher)
2. Re: Access to Health Care (Rajiv Bhatia)
3. Re: Access to Health Care (denita Jones)
4. Re: Access to Health Care (Rajiv Bhatia)
----------------------------------------------------------------------
Message: 1
Date: Fri, 28 Feb 2014 14:43:16 -0600
From: Ed Christopher <edc(a)berwyned.com<mailto:edc@berwyned.com>>
Subject: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <5310F4E4.9060008(a)berwyned.com<mailto:5310F4E4.9060008@berwyned.com>>
Content-Type: text/plain; charset=ISO-8859-1; format=flowed
I got asked a question today, from a transportation perspective, about access to health care and health facilities. As I started to hunt around on the web I thought I would throw it out to our Listserve. Does anyone know of any research, literature or other articles that they could pass along dealing with access to health care services?
Thanks
--
Ed Christopher
------------------------------
Message: 2
Date: Fri, 28 Feb 2014 13:13:39 -0800
From: Rajiv Bhatia <rb6419(a)gmail.com<mailto:rb6419@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com<mailto:73BF7334-5E7C-4BC7-8B00-1C6139B8B486@gmail.com>>
Content-Type: text/plain; charset=us-ascii
There is limited information on this topic. I did a review of this and other EJ impacts for EPA a few years ago.
A few studies have looked at transport access to facilities and their association to health outcomes. Most studies treated the "exposure variable" as auto ownership. Net conclusion is that auto owners have better access to health facilities. THere is a very limited association to health outcomes.
I would not take this as a null result -- just one that has been understudied.
Rajiv
------------------------------
Message: 3
Date: Fri, 28 Feb 2014 15:12:18 -0600
From: denita Jones <denita944(a)gmail.com<mailto:denita944@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID:
<CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=5vJ7_jHgdNnmA(a)mail.gmail.com<mailto:CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=5vJ7_jHgdNnmA@mail.gmail.com>>
Content-Type: text/plain; charset="iso-8859-1"
Im actually presenting research in that area in DC next month. I'm not in a
position now to give the names of articles (im driving) But I can send them
to you and suggest sites.
------------------------------
Message: 4
Date: Fri, 28 Feb 2014 18:58:16 -0800
From: Rajiv Bhatia <rb6419(a)gmail.com<mailto:rb6419@gmail.com>>
Subject: Re: [H+T--Friends] Access to Health Care
To: TRB Health and Transportation <h+t--friends(a)chrispy.net<mailto:h+t--friends@chrispy.net>>
Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54(a)gmail.com<mailto:B6368ACB-B234-45D2-87FB-80F7D05E9F54@gmail.com>>
Content-Type: text/plain; charset="us-ascii"
Ed
These are the studies I found in a 2009 review -- i'm sure there are new ones.
1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers to healthcare access in a non-elderly urban poor American population. Health and Social Care in the Community. 2001; 9:445-453.
2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR. Transportation barriers to accessing health care for urban children. Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer GE. Practical barriers to timely primary care access: impact on adult use of emergency department services. Archives in Internal Medicine. 2008; 168:1705-1710.
4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to transportation and health care utilization in a rural region. Journal of Rural Health. 2005; 21:31-38.
End of H+T--Friends Digest, Vol 35, Issue 1
*******************************************
These are great points - nice discussion! We are interested in both safety
and mobility topics and improving the coordination and quality of NEMT.
A colleague at Virginia DOT and I are interested in pursuing funding for a
renal transportation project. Aside from NCHRP - are there any
recommendations about who might be interested in funding that topic?
On Mon, Mar 3, 2014 at 10:00 AM, <h+t--friends-request(a)chrispy.net> wrote:
> Send H+T--Friends mailing list submissions to
> h+t--friends(a)chrispy.net
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> than "Re: Contents of H+T--Friends digest..."
>
>
> Today's Topics:
>
> 1. Transportation barriers, health care access and outcomes
> (Hank Weiss)
> 2. Re: Transportation barriers, health care access and outcomes
> (Sheryl Gross-Glaser)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Sun, 2 Mar 2014 19:44:58 +0000
> From: Hank Weiss <hank.weiss(a)otago.ac.nz>
> Subject: [H+T--Friends] Transportation barriers, health care access
> and outcomes
> To: "h+t--friends(a)chrispy.net" <h+t--friends(a)chrispy.net>
> Message-ID:
> <
> 476E461795D56248AE22F244F76E36B41260109B(a)ITS-EXM-P05.registry.otago.ac.nz>
>
> Content-Type: text/plain; charset="us-ascii"
>
> Kara:
>
> Thank you and Chris for sharing; this is great you are doing this work.
> Several other aspects are worth mentioning.
>
> The first is something I am sure some of the references discuss. Like the
> way we have built much of our infrastructure, little attention is paid to
> anything other than private motor vehicle access when planning health
> facilities. This sometimes leads to a false dichotomy by "blaming" lack of
> MV ownership/access as an important part of the problem. As people on this
> list serve know, it's more complex than that. Encouraging more/cheaper car
> use among people who cannot afford it is not the solution, especially when
> car dependency may be part of the reason why such people are in need of
> medical care in the first place! The many feedback loops and their
> directions are not yet well elucidated. A telling exercise is to go the
> public website of any hospital or clinic and look for walking, biking and
> transit directions.
>
> I would also suggest that such work not focus only on the sick patient and
> transport for care. It is often someone else who makes the transport
> decision. Further, the trips generated by inpatient illness episodes are
> mostly by employees, suppliers, family and friends, not the patient. One
> wonders if and how disparity in outcomes might be related to how difficult
> it is for family and friend supporters to be part of the disease care and
> recovery experience and the role accessibility plays.
>
> The injury dimension of transport mode and health outcomes also should not
> be neglected. There is a small separate literature that looks at the
> safety of EMS and ambulances from a patient perspective. National data are
> hard to come by, however. But ambulances and ambulance runs can be risky
> endeavors. Look for the work by Dr Nadine Levick. This pertains to
> non-ambulance trips as well. How many pregnant women and babies are injured
> during the urgent private drive to the hospital? I doubt such episodes are
> tracked and I doubt the risks of transport are ever calculated in cost
> benefit analyses of medical care planning or providing in almost any
> setting.
>
> Lastly, I can't put my finger on it at the moment, but there was a flurry
> of important work in this area during the 70's oil embargo for obvious
> reasons. As private car use and access declines on a per capita basis, a
> well-documented nine year trend*, the issues of transport and healthcare
> access will become more and more important.
>
> Hank Weiss
>
> ---------------------
> *"Evidence suggests that the decline is likely due to changing
> demographics, saturated highways, and a rising preference for compact,
> mixed-use neighborhoods, which reduce the need for driving" .
> http://www.ssti.us/2014/02/vmt-drops-ninth-year-dots-taking-notice/
>
>
>
> -----Original Message-----
> From: h+t--friends-bounces(a)chrispy.net [mailto:
> h+t--friends-bounces(a)chrispy.net] On Behalf Of
> h+t--friends-request(a)chrispy.net
> Sent: Monday, March 03, 2014 7:00 AM
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Sat, 1 Mar 2014 10:41:00 -0800
> From: "Kara E. MacLeod" <kara.e.m(a)gmail.com>
> Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 35, Issue 1
> To: h+t--friends(a)chrispy.net
> Message-ID:
> <CAGT3rCB0kN8MT5hSkMRX20CMLVbtXn8aOTAanmdjo3cqRZAE=
> A(a)mail.gmail.com>
> Content-Type: text/plain; charset="iso-8859-1"
>
> At UC Berkeley SafeTREC we are working on a Medicaid transportation study.
> Here is some background from one of our recent publications with
> references at the end.
>
> Transportation barriers have been associated with poorer health care
> access, differential treatment, missed or delayed medical appointments, and
> lower health status (Fitzpatrick, Powe, Cooper, Ives, & Robbins, 2004;
> Goodwin, Hunt, & Samet, 1993; Gwira et al., 2006; Horton & Johnson, 2010;
> Okoro, Strine, Young, Balluz, & Mokdad, 2005; Rittner & Kirk, 1995).
> Transportation has been recognized as a key ele- ment of health care
> access, which highlights its role to offset long-term health consequences.
> Delayed medical care may adversely affect patients' quality of life and
> result in more depressive symptoms (Owsley et al., 2007). These delays can
> also lead to an increased need for emergency care and pre- ventable
> hospitalizations and result in higher medical costs (Hughes-Cromwich &
> Wallace, 2006; Rust et al., 2008).
>
> Approximately 3.6 million adults miss or delay non- emergency medical care
> due to transportation barriers (Hughes-Cromwich & Wallace, 2006). The
> population missing these visits may be particularly susceptible to poorer
> health status and higher cost of care. These transpor- tation barriers are
> more likely to influence older individu- als, females, minorities, and
> those with lower income levels (Hughes-Cromwich & Wallace, 2006; U.S.
> Government Accountability Office, 2003). Medicaid acknowledges the
> importance of transportation for vulnerable populations and the associated
> potential costs of delayed medical care (Kim, Norton, & Stearns, 2009). In
> fact, federal Medicaid requires that states "ensure necessary
> transportation for recipients to and from providers" to help meet the needs
> of this population and the intent of Medicaid (The Hilltop Institute, 2008
> ).
>
> Bellamy,G. R., Stone,K., Richardson,S. K., & Goldsteen,R. L. (2003).
> Getting from here to there: Evaluating West Virginia's rural nonemergency
> medical transportation program. Journal of Rural Health, 19(Suppl), 397-406.
>
> Community Transportation Association of America. (2008). Federal Register,
> 73, 245. http://web1.ctaa.org/webmodules/webarticles/
> articlefiles/cms1219.pdf<http://web1.ctaa.org/webmodules/webarticles/articlefiles/cms1219.pdf>
> <http://web1.ctaa.org/webmodules/webarticles/articlefiles/cms1219.pdf>
> .
>
> Community Transportation Association of America. (2009). America's
> Affordable Health Choices Act of 2009. http://
> www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_
> BillText_071409.pdf<http://www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_BillText_0714…>
> <
> http://www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_BillText_0714…
> >.
>
>
> Community Transportation Association of America. (2010). An overview: How
> health care reform impacts community and public transportation.
> http://web1.ctaa.org/webmodules/webar-
> ticles/anmviewer.asp?a=1672&z=5<
> http://web1.ctaa.org/webmodules/webar-ticles/anmviewer.asp?a=1672&z=5>.
>
>
> Fitzpatrick,A. L., Powe,N. R., Cooper,L. S., Ives,D. G., & Robbins,J. A.
> (2004). Barriers to health care access among the elderly and who perceives
> them. American Journal of Public Health, 94, 1788-1794.
> http://dx.doi.org/10.2105/AJPH.94.10.1788.
>
> Goodwin,J. S., Hunt,W. C., & Samet,J. M. (1993). Determinants of cancer
> therapy in elderly patients. Cancer, 72, 594-601.
>
> Gwira,J. A., Vistamehr,S., Shelsta,H., Bashford,K., Forster,S.,
> Palmisano,P., Shafranov,G., & Shields,M. B. (2006). Factors associated with
> failure to follow up after glaucoma screening: a study in an African
> American population. Ophthalmology, 113, 1315-1319.
> http://dx.doi.org/10.1016/j.ophtha.2006.04.017
>
> Horton,S., & Johnson,R. J. (2010). Improving access to health care for
> uninsured elderly patients. Public Health Nursing, 27, 362- 370.
> doi:10.1111/j.1525-1446.2010.00866.x
>
> Hughes-Cromwich,P. & Wallace,R. (2006). Cost benefit analy- sis of
> providing non-emergency medical transportation. Transportation Research
> Record: Journal of the Transportation Research Board, 1956, 86-93.
> doi:10.3141/1956-11
>
> Kim,J., Norton,E. C., & Stearns,S. C. (2009). Transportation brokerage
> services and Medicaid beneficiaries' access to care. Health Services
> Research, 44, 145-161. doi:10.1111/j.1475-6773.2008.00907.x
>
> Leduc,N., Tannenbaum,T. N., Bergman,H., Champagne,F., Clarfield,A. M., &
> Kogan,S. (1998). Compliance of frail elderly with health services
> prescribed at discharge from an acute-care geriatric ward. Medical Care,
> 36, 904-914. doi:10.1097/00005650-199806000-00013
>
> Leutz,W., & Capitman,J. (2007). Met needs and unmet needs, and
> satisfaction among Social HMO members. Journal of Aging & Social Policy,
> 19, 1-19.
> doi:10.1300/J031v19n01_01
>
> Lynott,J., Fox-Grage,W., & Guzman,S. (2013). Weaving it together: A
> tapestry of transportation funding for older adults. AARP Public Policy
> Institute. http://www.aarp.org/research/ppi/liv-
> com2/policy/transportation/articles/weaving-it-together-trans-<http://www.aarp.org/research/ppi/liv-com2/policy/transportation/articles/we…>
> portation-funding-for-older-adults-AARP-ppi-liv-com.html<
> http://www.aarp.org/research/ppi/liv-com2/policy/transportation/articles/we…
> >
>
> Nasvadi,G. E. & Wister,A. V. (2006). Informal social support and use of a
> specialized transportation system by chronically ill older adults.
> Environment and Behavior, 38, 209-225. doi:10.1177/0013916505277605
>
> Owsley,C., McGwin,G. Jr, Scilley,K., Meek,G. C., Seker,D., & Dyer,A.
> (2007). Effect of refractive error correction on health-related quality of
> life and depression in older nursing home residents. Archives of
> Ophthalmology, 125, 1471-1477. doi:10.1001/ archopht.125.11.1471
>
> Rittner,B., & Kirk,A. B. (1995). Health care and public transpor- tation
> use by poor and frail elderly people. Social Work, 40, 365-373.
> http://search.proquest.com/docview/1297015299?acc
> ountid=14496 <
> http://search.proquest.com/docview/1297015299?accountid=14496>
>
> Rust,G., Ye,J., Baltrus,P., Daniels,E., Adesunloye,B., & Fryer,G. E.
> (2008). Practical barriers to timely primary care access: Impact on adult
> use of emergency department services. Archives of Internal Medicine, 168,
> 1705-1710. doi:10.1001/ archinte.168.15.1705
>
> The Hilltop Institute. (2008). Non-Emergency Medical Transportation (NEMT)
> Study Report. http://www.hilltopinsti-
> tute.org/publications/Non-EmergencyMedicalTransportationSt
> udyReport-September2008.pdf<http://tute.org/publications/Non-EmergencyMedicalTransportationStudyReport-…>
> <
> http://tute.org/publications/Non-EmergencyMedicalTransportationStudyReport-…
> >.
>
>
> Whittier,S., Scharlach,A. E., & Dal Santo,T. S. (2005). Availability of
> caregiver support services: Implications for implementation of the National
> Family Caregiver Support Program. Journal of Aging and Social Policy, 17,
> 45-62. doi:10.1300/J031v17n01_03
>
> Yeatts,D. E., Crow,T., & Folts,E. (1992). Service use among low- income
> minority elderly: Strategies for overcoming barriers. The Gerontologist,
> 32, 24-32. doi:10.1093/geront/32.1.24
>
>
>
>
> On Sat, Mar 1, 2014 at 10:00 AM, <h+t--friends-request(a)chrispy.net> wrote:
>
> >
> > Today's Topics:
> >
> > 1. Access to Health Care (Ed Christopher)
> > 2. Re: Access to Health Care (Rajiv Bhatia)
> > 3. Re: Access to Health Care (denita Jones)
> > 4. Re: Access to Health Care (Rajiv Bhatia)
> >
> >
> > ----------------------------------------------------------------------
> >
> > Message: 1
> > Date: Fri, 28 Feb 2014 14:43:16 -0600
> > From: Ed Christopher <edc(a)berwyned.com>
> > Subject: [H+T--Friends] Access to Health Care
> > To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> > Message-ID: <5310F4E4.9060008(a)berwyned.com>
> > Content-Type: text/plain; charset=ISO-8859-1; format=flowed
> >
> > I got asked a question today, from a transportation perspective, about
> > access to health care and health facilities. As I started to hunt
> > around on the web I thought I would throw it out to our Listserve.
> > Does anyone know of any research, literature or other articles that
> > they could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> >
> >
> > ------------------------------
> >
> > Message: 2
> > Date: Fri, 28 Feb 2014 13:13:39 -0800
> > From: Rajiv Bhatia <rb6419(a)gmail.com>
> > Subject: Re: [H+T--Friends] Access to Health Care
> > To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> > Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com>
> > Content-Type: text/plain; charset=us-ascii
> >
> > There is limited information on this topic. I did a review of this
> > and other EJ impacts for EPA a few years ago.
> >
> > A few studies have looked at transport access to facilities and their
> > association to health outcomes. Most studies treated the "exposure
> > variable" as auto ownership. Net conclusion is that auto owners have
> > better access to health facilities. THere is a very limited association
> > to health outcomes.
> >
> > I would not take this as a null result -- just one that has been
> > understudied.
> >
> > Rajiv
> >
> >
> >
> > On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
> >
> > > I got asked a question today, from a transportation perspective,
> > > about access to health care and health facilities. As I started to
> > > hunt around on the web I thought I would throw it out to our
> > > Listserve. Does anyone know of any research, literature or other
> > > articles that they could pass along dealing with access to health care
> services?
> > >
> > > Thanks
> > > --
> > > Ed Christopher
> > > _______________________________________________
> > > H+T--Friends mailing list
> > > H+T--Friends(a)chrispy.net
> > > https://www.chrispy.net/mailman/listinfo/h+t--friends
> >
> >
> >
> >
> > ------------------------------
> >
> > Message: 3
> > Date: Fri, 28 Feb 2014 15:12:18 -0600
> > From: denita Jones <denita944(a)gmail.com>
> > Subject: Re: [H+T--Friends] Access to Health Care
> > To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> > Message-ID:
> > <CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=
> > 5vJ7_jHgdNnmA(a)mail.gmail.com>
> > Content-Type: text/plain; charset="iso-8859-1"
> >
> > Im actually presenting research in that area in DC next month. I'm not
> > in a position now to give the names of articles (im driving) But I can
> > send them to you and suggest sites.
> > On Feb 28, 2014 3:07 PM, "Ed Christopher" <edc(a)berwyned.com> wrote:
> >
> > > I got asked a question today, from a transportation perspective,
> > > about access to health care and health facilities. As I started to
> > > hunt around on the web I thought I would throw it out to our
> > > Listserve. Does anyone know of any research, literature or other
> > > articles that they could pass along dealing with access to health care
> services?
> > >
> > > Thanks
> > > --
> > > Ed Christopher
> > > _______________________________________________
> > > H+T--Friends mailing list
> > > H+T--Friends(a)chrispy.net
> > > https://www.chrispy.net/mailman/listinfo/h+t--friends
> > >
> > -------------- next part -------------- An HTML attachment was
> > scrubbed...
> > URL:
> > https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/26
> > 257ec5/attachment-0001.html
> >
> > ------------------------------
> >
> > Message: 4
> > Date: Fri, 28 Feb 2014 18:58:16 -0800
> > From: Rajiv Bhatia <rb6419(a)gmail.com>
> > Subject: Re: [H+T--Friends] Access to Health Care
> > To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> > Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54(a)gmail.com>
> > Content-Type: text/plain; charset="us-ascii"
> >
> > Ed
> >
> > These are the studies I found in a 2009 review -- i'm sure there are
> > new ones.
> >
> > 1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers
> > to healthcare access in a non-elderly urban poor American population.
> > Health and Social Care in the Community. 2001; 9:445-453.
> >
> > 2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR.
> > Transportation barriers to accessing health care for urban children.
> > Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
> >
> > 3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer
> > GE. Practical barriers to timely primary care access: impact on adult
> > use of emergency department services. Archives in Internal Medicine.
> > 2008; 168:1705-1710.
> >
> > 4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to
> > transportation and health care utilization in a rural region. Journal
> > of Rural Health. 2005; 21:31-38.
> >
> >
> >
> > On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
> >
> > > I got asked a question today, from a transportation perspective,
> > > about access to health care and health facilities. As I started to
> > > hunt around on the web I thought I would throw it out to our
> > > Listserve. Does anyone know of any research, literature or other
> > > articles that they could pass along dealing with access to health care
> services?
> > >
> > > Thanks
> > > --
> > > Ed Christopher
> > > _______________________________________________
> > > H+T--Friends mailing list
> > > H+T--Friends(a)chrispy.net
> > > https://www.chrispy.net/mailman/listinfo/h+t--friends
> >
> > -------------- next part -------------- An HTML attachment was
> > scrubbed...
> > URL:
> > https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/d5
> > 9c5e33/attachment-0001.html
> >
> > ------------------------------
> >
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
> >
> >
> > End of H+T--Friends Digest, Vol 35, Issue 1
> > *******************************************
> >
>
A little background and an admission that I am not a researcher. Medicaid, which, unlike Medicare, operates differently in every state, is required to provide transportation for its clients, but no other healthcare insurers, including Medicare, are obligated to do so. That means that many older adults and those who became ill in mid-life who are unable to or who cannot afford to drive are dependent on under-funded non-profit transportation providers and volunteer transportation programs. Medicaid's "guarantee" of transportation does not mean convenient transportation or transportation coordinated with medical care. Indeed, in some states one might strongly suspect that the low quality of transportation provided constitutes a strong inducement to find alternative transportation, thereby magically reducing the financial burden on the state. However, the increase in the numbers of dialysis patients, who need transportation a few times a week, and behavioural health patients are straining the system in many states, causing further erosion in the quality of non-emergency Medicaid transportation from a patient perspective.
There is, of course, much more to be said, but the combination of communities designed against maintenance of health and the poor access to transportation for healthcare makes health a more difficult status to achieve or maintain for individuals and families who are poor.
Excuse me if I have rattled on about something you are already familiar with.
Hank Weiss <hank.weiss(a)otago.ac.nz> wrote:
>Kara:
>
>Thank you and Chris for sharing; this is great you are doing this work. Several other aspects are worth mentioning.
>
>The first is something I am sure some of the references discuss. Like the way we have built much of our infrastructure, little attention is paid to anything other than private motor vehicle access when planning health facilities. This sometimes leads to a false dichotomy by "blaming" lack of MV ownership/access as an important part of the problem. As people on this list serve know, it's more complex than that. Encouraging more/cheaper car use among people who cannot afford it is not the solution, especially when car dependency may be part of the reason why such people are in need of medical care in the first place! The many feedback loops and their directions are not yet well elucidated. A telling exercise is to go the public website of any hospital or clinic and look for walking, biking and transit directions.
>
>I would also suggest that such work not focus only on the sick patient and transport for care. It is often someone else who makes the transport decision. Further, the trips generated by inpatient illness episodes are mostly by employees, suppliers, family and friends, not the patient. One wonders if and how disparity in outcomes might be related to how difficult it is for family and friend supporters to be part of the disease care and recovery experience and the role accessibility plays.
>
>The injury dimension of transport mode and health outcomes also should not be neglected. There is a small separate literature that looks at the safety of EMS and ambulances from a patient perspective. National data are hard to come by, however. But ambulances and ambulance runs can be risky endeavors. Look for the work by Dr Nadine Levick. This pertains to non-ambulance trips as well. How many pregnant women and babies are injured during the urgent private drive to the hospital? I doubt such episodes are tracked and I doubt the risks of transport are ever calculated in cost benefit analyses of medical care planning or providing in almost any setting.
>
>Lastly, I can't put my finger on it at the moment, but there was a flurry of important work in this area during the 70's oil embargo for obvious reasons. As private car use and access declines on a per capita basis, a well-documented nine year trend*, the issues of transport and healthcare access will become more and more important.
>
>Hank Weiss
>
>---------------------
>*"Evidence suggests that the decline is likely due to changing demographics, saturated highways, and a rising preference for compact, mixed-use neighborhoods, which reduce the need for driving" . http://www.ssti.us/2014/02/vmt-drops-ninth-year-dots-taking-notice/
>
>
>
>-----Original Message-----
>From: h+t--friends-bounces(a)chrispy.net [mailto:h+t--friends-bounces@chrispy.net] On Behalf Of h+t--friends-request(a)chrispy.net
>Sent: Monday, March 03, 2014 7:00 AM
>----------------------------------------------------------------------
>
>Message: 1
>Date: Sat, 1 Mar 2014 10:41:00 -0800
>From: "Kara E. MacLeod" <kara.e.m(a)gmail.com>
>Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 35, Issue 1
>To: h+t--friends(a)chrispy.net
>Message-ID:
> <CAGT3rCB0kN8MT5hSkMRX20CMLVbtXn8aOTAanmdjo3cqRZAE=A(a)mail.gmail.com>
>Content-Type: text/plain; charset="iso-8859-1"
>
>At UC Berkeley SafeTREC we are working on a Medicaid transportation study.
> Here is some background from one of our recent publications with references at the end.
>
> Transportation barriers have been associated with poorer health care access, differential treatment, missed or delayed medical appointments, and lower health status (Fitzpatrick, Powe, Cooper, Ives, & Robbins, 2004; Goodwin, Hunt, & Samet, 1993; Gwira et al., 2006; Horton & Johnson, 2010; Okoro, Strine, Young, Balluz, & Mokdad, 2005; Rittner & Kirk, 1995).
>Transportation has been recognized as a key ele- ment of health care access, which highlights its role to offset long-term health consequences.
>Delayed medical care may adversely affect patients' quality of life and result in more depressive symptoms (Owsley et al., 2007). These delays can also lead to an increased need for emergency care and pre- ventable hospitalizations and result in higher medical costs (Hughes-Cromwich & Wallace, 2006; Rust et al., 2008).
>
>Approximately 3.6 million adults miss or delay non- emergency medical care due to transportation barriers (Hughes-Cromwich & Wallace, 2006). The population missing these visits may be particularly susceptible to poorer health status and higher cost of care. These transpor- tation barriers are more likely to influence older individu- als, females, minorities, and those with lower income levels (Hughes-Cromwich & Wallace, 2006; U.S.
>Government Accountability Office, 2003). Medicaid acknowledges the importance of transportation for vulnerable populations and the associated potential costs of delayed medical care (Kim, Norton, & Stearns, 2009). In fact, federal Medicaid requires that states "ensure necessary transportation for recipients to and from providers" to help meet the needs of this population and the intent of Medicaid (The Hilltop Institute, 2008 ).
>
>Bellamy,G. R., Stone,K., Richardson,S. K., & Goldsteen,R. L. (2003).
>Getting from here to there: Evaluating West Virginia's rural nonemergency medical transportation program. Journal of Rural Health, 19(Suppl), 397-406.
>
>Community Transportation Association of America. (2008). Federal Register, 73, 245. http://web1.ctaa.org/webmodules/webarticles/
>articlefiles/cms1219.pdf<http://web1.ctaa.org/webmodules/webarticles/articlefiles/cms1219.pdf>
>.
>
>Community Transportation Association of America. (2009). America's Affordable Health Choices Act of 2009. http:// www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_
>BillText_071409.pdf<http://www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_BillText_0714…>.
>
>
>Community Transportation Association of America. (2010). An overview: How health care reform impacts community and public transportation.
>http://web1.ctaa.org/webmodules/webar-
>ticles/anmviewer.asp?a=1672&z=5<http://web1.ctaa.org/webmodules/webar-ticles/anmviewer.asp?a=1672&z=5>.
>
>
>Fitzpatrick,A. L., Powe,N. R., Cooper,L. S., Ives,D. G., & Robbins,J. A.
>(2004). Barriers to health care access among the elderly and who perceives them. American Journal of Public Health, 94, 1788-1794.
>http://dx.doi.org/10.2105/AJPH.94.10.1788.
>
>Goodwin,J. S., Hunt,W. C., & Samet,J. M. (1993). Determinants of cancer therapy in elderly patients. Cancer, 72, 594-601.
>
>Gwira,J. A., Vistamehr,S., Shelsta,H., Bashford,K., Forster,S., Palmisano,P., Shafranov,G., & Shields,M. B. (2006). Factors associated with failure to follow up after glaucoma screening: a study in an African American population. Ophthalmology, 113, 1315-1319.
>http://dx.doi.org/10.1016/j.ophtha.2006.04.017
>
>Horton,S., & Johnson,R. J. (2010). Improving access to health care for uninsured elderly patients. Public Health Nursing, 27, 362- 370.
>doi:10.1111/j.1525-1446.2010.00866.x
>
>Hughes-Cromwich,P. & Wallace,R. (2006). Cost benefit analy- sis of providing non-emergency medical transportation. Transportation Research
>Record: Journal of the Transportation Research Board, 1956, 86-93.
>doi:10.3141/1956-11
>
>Kim,J., Norton,E. C., & Stearns,S. C. (2009). Transportation brokerage services and Medicaid beneficiaries' access to care. Health Services Research, 44, 145-161. doi:10.1111/j.1475-6773.2008.00907.x
>
> Leduc,N., Tannenbaum,T. N., Bergman,H., Champagne,F., Clarfield,A. M., & Kogan,S. (1998). Compliance of frail elderly with health services prescribed at discharge from an acute-care geriatric ward. Medical Care, 36, 904-914. doi:10.1097/00005650-199806000-00013
>
>Leutz,W., & Capitman,J. (2007). Met needs and unmet needs, and satisfaction among Social HMO members. Journal of Aging & Social Policy, 19, 1-19.
>doi:10.1300/J031v19n01_01
>
>Lynott,J., Fox-Grage,W., & Guzman,S. (2013). Weaving it together: A tapestry of transportation funding for older adults. AARP Public Policy Institute. http://www.aarp.org/research/ppi/liv-
>com2/policy/transportation/articles/weaving-it-together-trans-
>portation-funding-for-older-adults-AARP-ppi-liv-com.html<http://www.aarp.org/research/ppi/liv-com2/policy/transportation/articles/we…>
>
>Nasvadi,G. E. & Wister,A. V. (2006). Informal social support and use of a specialized transportation system by chronically ill older adults. Environment and Behavior, 38, 209-225. doi:10.1177/0013916505277605
>
>Owsley,C., McGwin,G. Jr, Scilley,K., Meek,G. C., Seker,D., & Dyer,A.
>(2007). Effect of refractive error correction on health-related quality of life and depression in older nursing home residents. Archives of Ophthalmology, 125, 1471-1477. doi:10.1001/ archopht.125.11.1471
>
>Rittner,B., & Kirk,A. B. (1995). Health care and public transpor- tation use by poor and frail elderly people. Social Work, 40, 365-373.
>http://search.proquest.com/docview/1297015299?acc
>ountid=14496 <http://search.proquest.com/docview/1297015299?accountid=14496>
>
>Rust,G., Ye,J., Baltrus,P., Daniels,E., Adesunloye,B., & Fryer,G. E.
>(2008). Practical barriers to timely primary care access: Impact on adult use of emergency department services. Archives of Internal Medicine, 168, 1705-1710. doi:10.1001/ archinte.168.15.1705
>
>The Hilltop Institute. (2008). Non-Emergency Medical Transportation (NEMT) Study Report. http://www.hilltopinsti-tute.org/publications/Non-EmergencyMedicalTransportationSt
>udyReport-September2008.pdf<http://tute.org/publications/Non-EmergencyMedicalTransportationStudyReport-…>.
>
>
>Whittier,S., Scharlach,A. E., & Dal Santo,T. S. (2005). Availability of caregiver support services: Implications for implementation of the National Family Caregiver Support Program. Journal of Aging and Social Policy, 17, 45-62. doi:10.1300/J031v17n01_03
>
>Yeatts,D. E., Crow,T., & Folts,E. (1992). Service use among low- income minority elderly: Strategies for overcoming barriers. The Gerontologist, 32, 24-32. doi:10.1093/geront/32.1.24
>
>
>
>
>On Sat, Mar 1, 2014 at 10:00 AM, <h+t--friends-request(a)chrispy.net> wrote:
>
>>
>> Today's Topics:
>>
>> 1. Access to Health Care (Ed Christopher)
>> 2. Re: Access to Health Care (Rajiv Bhatia)
>> 3. Re: Access to Health Care (denita Jones)
>> 4. Re: Access to Health Care (Rajiv Bhatia)
>>
>>
>> ----------------------------------------------------------------------
>>
>> Message: 1
>> Date: Fri, 28 Feb 2014 14:43:16 -0600
>> From: Ed Christopher <edc(a)berwyned.com>
>> Subject: [H+T--Friends] Access to Health Care
>> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
>> Message-ID: <5310F4E4.9060008(a)berwyned.com>
>> Content-Type: text/plain; charset=ISO-8859-1; format=flowed
>>
>> I got asked a question today, from a transportation perspective, about
>> access to health care and health facilities. As I started to hunt
>> around on the web I thought I would throw it out to our Listserve.
>> Does anyone know of any research, literature or other articles that
>> they could pass along dealing with access to health care services?
>>
>> Thanks
>> --
>> Ed Christopher
>>
>>
>> ------------------------------
>>
>> Message: 2
>> Date: Fri, 28 Feb 2014 13:13:39 -0800
>> From: Rajiv Bhatia <rb6419(a)gmail.com>
>> Subject: Re: [H+T--Friends] Access to Health Care
>> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
>> Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com>
>> Content-Type: text/plain; charset=us-ascii
>>
>> There is limited information on this topic. I did a review of this
>> and other EJ impacts for EPA a few years ago.
>>
>> A few studies have looked at transport access to facilities and their
>> association to health outcomes. Most studies treated the "exposure
>> variable" as auto ownership. Net conclusion is that auto owners have
>> better access to health facilities. THere is a very limited association
>> to health outcomes.
>>
>> I would not take this as a null result -- just one that has been
>> understudied.
>>
>> Rajiv
>>
>>
>>
>> On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
>>
>> > I got asked a question today, from a transportation perspective,
>> > about access to health care and health facilities. As I started to
>> > hunt around on the web I thought I would throw it out to our
>> > Listserve. Does anyone know of any research, literature or other
>> > articles that they could pass along dealing with access to health care services?
>> >
>> > Thanks
>> > --
>> > Ed Christopher
>> > _______________________________________________
>> > H+T--Friends mailing list
>> > H+T--Friends(a)chrispy.net
>> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>>
>>
>>
>>
>> ------------------------------
>>
>> Message: 3
>> Date: Fri, 28 Feb 2014 15:12:18 -0600
>> From: denita Jones <denita944(a)gmail.com>
>> Subject: Re: [H+T--Friends] Access to Health Care
>> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
>> Message-ID:
>> <CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=
>> 5vJ7_jHgdNnmA(a)mail.gmail.com>
>> Content-Type: text/plain; charset="iso-8859-1"
>>
>> Im actually presenting research in that area in DC next month. I'm not
>> in a position now to give the names of articles (im driving) But I can
>> send them to you and suggest sites.
>> On Feb 28, 2014 3:07 PM, "Ed Christopher" <edc(a)berwyned.com> wrote:
>>
>> > I got asked a question today, from a transportation perspective,
>> > about access to health care and health facilities. As I started to
>> > hunt around on the web I thought I would throw it out to our
>> > Listserve. Does anyone know of any research, literature or other
>> > articles that they could pass along dealing with access to health care services?
>> >
>> > Thanks
>> > --
>> > Ed Christopher
>> > _______________________________________________
>> > H+T--Friends mailing list
>> > H+T--Friends(a)chrispy.net
>> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>> >
>> -------------- next part -------------- An HTML attachment was
>> scrubbed...
>> URL:
>> https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/26
>> 257ec5/attachment-0001.html
>>
>> ------------------------------
>>
>> Message: 4
>> Date: Fri, 28 Feb 2014 18:58:16 -0800
>> From: Rajiv Bhatia <rb6419(a)gmail.com>
>> Subject: Re: [H+T--Friends] Access to Health Care
>> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
>> Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54(a)gmail.com>
>> Content-Type: text/plain; charset="us-ascii"
>>
>> Ed
>>
>> These are the studies I found in a 2009 review -- i'm sure there are
>> new ones.
>>
>> 1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers
>> to healthcare access in a non-elderly urban poor American population.
>> Health and Social Care in the Community. 2001; 9:445-453.
>>
>> 2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR.
>> Transportation barriers to accessing health care for urban children.
>> Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
>>
>> 3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer
>> GE. Practical barriers to timely primary care access: impact on adult
>> use of emergency department services. Archives in Internal Medicine.
>> 2008; 168:1705-1710.
>>
>> 4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to
>> transportation and health care utilization in a rural region. Journal
>> of Rural Health. 2005; 21:31-38.
>>
>>
>>
>> On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
>>
>> > I got asked a question today, from a transportation perspective,
>> > about access to health care and health facilities. As I started to
>> > hunt around on the web I thought I would throw it out to our
>> > Listserve. Does anyone know of any research, literature or other
>> > articles that they could pass along dealing with access to health care services?
>> >
>> > Thanks
>> > --
>> > Ed Christopher
>> > _______________________________________________
>> > H+T--Friends mailing list
>> > H+T--Friends(a)chrispy.net
>> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>>
>> -------------- next part -------------- An HTML attachment was
>> scrubbed...
>> URL:
>> https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/d5
>> 9c5e33/attachment-0001.html
>>
>> ------------------------------
>>
>> _______________________________________________
>> H+T--Friends mailing list
>> H+T--Friends(a)chrispy.net
>> https://www.chrispy.net/mailman/listinfo/h+t--friends
>>
>>
>> End of H+T--Friends Digest, Vol 35, Issue 1
>> *******************************************
>>
>
Kara:
Thank you and Chris for sharing; this is great you are doing this work. Several other aspects are worth mentioning.
The first is something I am sure some of the references discuss. Like the way we have built much of our infrastructure, little attention is paid to anything other than private motor vehicle access when planning health facilities. This sometimes leads to a false dichotomy by "blaming" lack of MV ownership/access as an important part of the problem. As people on this list serve know, it's more complex than that. Encouraging more/cheaper car use among people who cannot afford it is not the solution, especially when car dependency may be part of the reason why such people are in need of medical care in the first place! The many feedback loops and their directions are not yet well elucidated. A telling exercise is to go the public website of any hospital or clinic and look for walking, biking and transit directions.
I would also suggest that such work not focus only on the sick patient and transport for care. It is often someone else who makes the transport decision. Further, the trips generated by inpatient illness episodes are mostly by employees, suppliers, family and friends, not the patient. One wonders if and how disparity in outcomes might be related to how difficult it is for family and friend supporters to be part of the disease care and recovery experience and the role accessibility plays.
The injury dimension of transport mode and health outcomes also should not be neglected. There is a small separate literature that looks at the safety of EMS and ambulances from a patient perspective. National data are hard to come by, however. But ambulances and ambulance runs can be risky endeavors. Look for the work by Dr Nadine Levick. This pertains to non-ambulance trips as well. How many pregnant women and babies are injured during the urgent private drive to the hospital? I doubt such episodes are tracked and I doubt the risks of transport are ever calculated in cost benefit analyses of medical care planning or providing in almost any setting.
Lastly, I can't put my finger on it at the moment, but there was a flurry of important work in this area during the 70's oil embargo for obvious reasons. As private car use and access declines on a per capita basis, a well-documented nine year trend*, the issues of transport and healthcare access will become more and more important.
Hank Weiss
---------------------
*"Evidence suggests that the decline is likely due to changing demographics, saturated highways, and a rising preference for compact, mixed-use neighborhoods, which reduce the need for driving" . http://www.ssti.us/2014/02/vmt-drops-ninth-year-dots-taking-notice/
-----Original Message-----
From: h+t--friends-bounces(a)chrispy.net [mailto:h+t--friends-bounces@chrispy.net] On Behalf Of h+t--friends-request(a)chrispy.net
Sent: Monday, March 03, 2014 7:00 AM
----------------------------------------------------------------------
Message: 1
Date: Sat, 1 Mar 2014 10:41:00 -0800
From: "Kara E. MacLeod" <kara.e.m(a)gmail.com>
Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 35, Issue 1
To: h+t--friends(a)chrispy.net
Message-ID:
<CAGT3rCB0kN8MT5hSkMRX20CMLVbtXn8aOTAanmdjo3cqRZAE=A(a)mail.gmail.com>
Content-Type: text/plain; charset="iso-8859-1"
At UC Berkeley SafeTREC we are working on a Medicaid transportation study.
Here is some background from one of our recent publications with references at the end.
Transportation barriers have been associated with poorer health care access, differential treatment, missed or delayed medical appointments, and lower health status (Fitzpatrick, Powe, Cooper, Ives, & Robbins, 2004; Goodwin, Hunt, & Samet, 1993; Gwira et al., 2006; Horton & Johnson, 2010; Okoro, Strine, Young, Balluz, & Mokdad, 2005; Rittner & Kirk, 1995).
Transportation has been recognized as a key ele- ment of health care access, which highlights its role to offset long-term health consequences.
Delayed medical care may adversely affect patients' quality of life and result in more depressive symptoms (Owsley et al., 2007). These delays can also lead to an increased need for emergency care and pre- ventable hospitalizations and result in higher medical costs (Hughes-Cromwich & Wallace, 2006; Rust et al., 2008).
Approximately 3.6 million adults miss or delay non- emergency medical care due to transportation barriers (Hughes-Cromwich & Wallace, 2006). The population missing these visits may be particularly susceptible to poorer health status and higher cost of care. These transpor- tation barriers are more likely to influence older individu- als, females, minorities, and those with lower income levels (Hughes-Cromwich & Wallace, 2006; U.S.
Government Accountability Office, 2003). Medicaid acknowledges the importance of transportation for vulnerable populations and the associated potential costs of delayed medical care (Kim, Norton, & Stearns, 2009). In fact, federal Medicaid requires that states "ensure necessary transportation for recipients to and from providers" to help meet the needs of this population and the intent of Medicaid (The Hilltop Institute, 2008 ).
Bellamy,G. R., Stone,K., Richardson,S. K., & Goldsteen,R. L. (2003).
Getting from here to there: Evaluating West Virginia's rural nonemergency medical transportation program. Journal of Rural Health, 19(Suppl), 397-406.
Community Transportation Association of America. (2008). Federal Register, 73, 245. http://web1.ctaa.org/webmodules/webarticles/
articlefiles/cms1219.pdf<http://web1.ctaa.org/webmodules/webarticles/articlefiles/cms1219.pdf>
.
Community Transportation Association of America. (2009). America's Affordable Health Choices Act of 2009. http:// www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_
BillText_071409.pdf<http://www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_BillText_0714…>.
Community Transportation Association of America. (2010). An overview: How health care reform impacts community and public transportation.
http://web1.ctaa.org/webmodules/webar-
ticles/anmviewer.asp?a=1672&z=5<http://web1.ctaa.org/webmodules/webar-ticles/anmviewer.asp?a=1672&z=5>.
Fitzpatrick,A. L., Powe,N. R., Cooper,L. S., Ives,D. G., & Robbins,J. A.
(2004). Barriers to health care access among the elderly and who perceives them. American Journal of Public Health, 94, 1788-1794.
http://dx.doi.org/10.2105/AJPH.94.10.1788.
Goodwin,J. S., Hunt,W. C., & Samet,J. M. (1993). Determinants of cancer therapy in elderly patients. Cancer, 72, 594-601.
Gwira,J. A., Vistamehr,S., Shelsta,H., Bashford,K., Forster,S., Palmisano,P., Shafranov,G., & Shields,M. B. (2006). Factors associated with failure to follow up after glaucoma screening: a study in an African American population. Ophthalmology, 113, 1315-1319.
http://dx.doi.org/10.1016/j.ophtha.2006.04.017
Horton,S., & Johnson,R. J. (2010). Improving access to health care for uninsured elderly patients. Public Health Nursing, 27, 362- 370.
doi:10.1111/j.1525-1446.2010.00866.x
Hughes-Cromwich,P. & Wallace,R. (2006). Cost benefit analy- sis of providing non-emergency medical transportation. Transportation Research
Record: Journal of the Transportation Research Board, 1956, 86-93.
doi:10.3141/1956-11
Kim,J., Norton,E. C., & Stearns,S. C. (2009). Transportation brokerage services and Medicaid beneficiaries' access to care. Health Services Research, 44, 145-161. doi:10.1111/j.1475-6773.2008.00907.x
Leduc,N., Tannenbaum,T. N., Bergman,H., Champagne,F., Clarfield,A. M., & Kogan,S. (1998). Compliance of frail elderly with health services prescribed at discharge from an acute-care geriatric ward. Medical Care, 36, 904-914. doi:10.1097/00005650-199806000-00013
Leutz,W., & Capitman,J. (2007). Met needs and unmet needs, and satisfaction among Social HMO members. Journal of Aging & Social Policy, 19, 1-19.
doi:10.1300/J031v19n01_01
Lynott,J., Fox-Grage,W., & Guzman,S. (2013). Weaving it together: A tapestry of transportation funding for older adults. AARP Public Policy Institute. http://www.aarp.org/research/ppi/liv-
com2/policy/transportation/articles/weaving-it-together-trans-
portation-funding-for-older-adults-AARP-ppi-liv-com.html<http://www.aarp.org/research/ppi/liv-com2/policy/transportation/articles/we…>
Nasvadi,G. E. & Wister,A. V. (2006). Informal social support and use of a specialized transportation system by chronically ill older adults. Environment and Behavior, 38, 209-225. doi:10.1177/0013916505277605
Owsley,C., McGwin,G. Jr, Scilley,K., Meek,G. C., Seker,D., & Dyer,A.
(2007). Effect of refractive error correction on health-related quality of life and depression in older nursing home residents. Archives of Ophthalmology, 125, 1471-1477. doi:10.1001/ archopht.125.11.1471
Rittner,B., & Kirk,A. B. (1995). Health care and public transpor- tation use by poor and frail elderly people. Social Work, 40, 365-373.
http://search.proquest.com/docview/1297015299?acc
ountid=14496 <http://search.proquest.com/docview/1297015299?accountid=14496>
Rust,G., Ye,J., Baltrus,P., Daniels,E., Adesunloye,B., & Fryer,G. E.
(2008). Practical barriers to timely primary care access: Impact on adult use of emergency department services. Archives of Internal Medicine, 168, 1705-1710. doi:10.1001/ archinte.168.15.1705
The Hilltop Institute. (2008). Non-Emergency Medical Transportation (NEMT) Study Report. http://www.hilltopinsti-tute.org/publications/Non-EmergencyMedicalTransportationSt
udyReport-September2008.pdf<http://tute.org/publications/Non-EmergencyMedicalTransportationStudyReport-…>.
Whittier,S., Scharlach,A. E., & Dal Santo,T. S. (2005). Availability of caregiver support services: Implications for implementation of the National Family Caregiver Support Program. Journal of Aging and Social Policy, 17, 45-62. doi:10.1300/J031v17n01_03
Yeatts,D. E., Crow,T., & Folts,E. (1992). Service use among low- income minority elderly: Strategies for overcoming barriers. The Gerontologist, 32, 24-32. doi:10.1093/geront/32.1.24
On Sat, Mar 1, 2014 at 10:00 AM, <h+t--friends-request(a)chrispy.net> wrote:
>
> Today's Topics:
>
> 1. Access to Health Care (Ed Christopher)
> 2. Re: Access to Health Care (Rajiv Bhatia)
> 3. Re: Access to Health Care (denita Jones)
> 4. Re: Access to Health Care (Rajiv Bhatia)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Fri, 28 Feb 2014 14:43:16 -0600
> From: Ed Christopher <edc(a)berwyned.com>
> Subject: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID: <5310F4E4.9060008(a)berwyned.com>
> Content-Type: text/plain; charset=ISO-8859-1; format=flowed
>
> I got asked a question today, from a transportation perspective, about
> access to health care and health facilities. As I started to hunt
> around on the web I thought I would throw it out to our Listserve.
> Does anyone know of any research, literature or other articles that
> they could pass along dealing with access to health care services?
>
> Thanks
> --
> Ed Christopher
>
>
> ------------------------------
>
> Message: 2
> Date: Fri, 28 Feb 2014 13:13:39 -0800
> From: Rajiv Bhatia <rb6419(a)gmail.com>
> Subject: Re: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com>
> Content-Type: text/plain; charset=us-ascii
>
> There is limited information on this topic. I did a review of this
> and other EJ impacts for EPA a few years ago.
>
> A few studies have looked at transport access to facilities and their
> association to health outcomes. Most studies treated the "exposure
> variable" as auto ownership. Net conclusion is that auto owners have
> better access to health facilities. THere is a very limited association
> to health outcomes.
>
> I would not take this as a null result -- just one that has been
> understudied.
>
> Rajiv
>
>
>
> On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
>
> > I got asked a question today, from a transportation perspective,
> > about access to health care and health facilities. As I started to
> > hunt around on the web I thought I would throw it out to our
> > Listserve. Does anyone know of any research, literature or other
> > articles that they could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>
>
>
>
> ------------------------------
>
> Message: 3
> Date: Fri, 28 Feb 2014 15:12:18 -0600
> From: denita Jones <denita944(a)gmail.com>
> Subject: Re: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID:
> <CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=
> 5vJ7_jHgdNnmA(a)mail.gmail.com>
> Content-Type: text/plain; charset="iso-8859-1"
>
> Im actually presenting research in that area in DC next month. I'm not
> in a position now to give the names of articles (im driving) But I can
> send them to you and suggest sites.
> On Feb 28, 2014 3:07 PM, "Ed Christopher" <edc(a)berwyned.com> wrote:
>
> > I got asked a question today, from a transportation perspective,
> > about access to health care and health facilities. As I started to
> > hunt around on the web I thought I would throw it out to our
> > Listserve. Does anyone know of any research, literature or other
> > articles that they could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
> >
> -------------- next part -------------- An HTML attachment was
> scrubbed...
> URL:
> https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/26
> 257ec5/attachment-0001.html
>
> ------------------------------
>
> Message: 4
> Date: Fri, 28 Feb 2014 18:58:16 -0800
> From: Rajiv Bhatia <rb6419(a)gmail.com>
> Subject: Re: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID: <B6368ACB-B234-45D2-87FB-80F7D05E9F54(a)gmail.com>
> Content-Type: text/plain; charset="us-ascii"
>
> Ed
>
> These are the studies I found in a 2009 review -- i'm sure there are
> new ones.
>
> 1. Ahmed SM, Lemkau JP, Nealeigh N, and Mann B. Barriers
> to healthcare access in a non-elderly urban poor American population.
> Health and Social Care in the Community. 2001; 9:445-453.
>
> 2. Yang S, Zarr RL, Kass-Hout TA, Kourosh A, Kelly NR.
> Transportation barriers to accessing health care for urban children.
> Journal of Health Care for the Poor and Underserved. 2006; 17:928-43.
>
> 3. Rust G, Ye J, Baltrus P, Daniels E, Adesunloye B, Fryer
> GE. Practical barriers to timely primary care access: impact on adult
> use of emergency department services. Archives in Internal Medicine.
> 2008; 168:1705-1710.
>
> 4. Arcury TA, Preisser JS, Gesler WM, Powers JM. Access to
> transportation and health care utilization in a rural region. Journal
> of Rural Health. 2005; 21:31-38.
>
>
>
> On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
>
> > I got asked a question today, from a transportation perspective,
> > about access to health care and health facilities. As I started to
> > hunt around on the web I thought I would throw it out to our
> > Listserve. Does anyone know of any research, literature or other
> > articles that they could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>
> -------------- next part -------------- An HTML attachment was
> scrubbed...
> URL:
> https://www.chrispy.net/pipermail/h+t--friends/attachments/20140228/d5
> 9c5e33/attachment-0001.html
>
> ------------------------------
>
> _______________________________________________
> H+T--Friends mailing list
> H+T--Friends(a)chrispy.net
> https://www.chrispy.net/mailman/listinfo/h+t--friends
>
>
> End of H+T--Friends Digest, Vol 35, Issue 1
> *******************************************
>
Dear All:
This report was done to impact the expendature plans for several
half cent transportation sales taxes in the San Francisco Bay Area.
Roadblocks to Health 2002 An analysis of transportation
barriers faced by low-income communities in accessing health services
and healthy activities in Alameda, Contra Costa and Santa Clara
counties. With recommendations.
http://transformca.org/resource/roadblocks-health
-- Chris Peeples --
=====================================
H. E. Christian (Chris) Peeples
At-Large Director
Alameda-Contra Costa Transit District
1600 Franklin Street, 10th Floor
Oakland, California 94612-2800
cpeeples(a)actransit.org
www.actransit.org
=====================================
At UC Berkeley SafeTREC we are working on a Medicaid transportation study.
Here is some background from one of our recent publications with
references at the end.
Transportation barriers have been associated with poorer health care
access, differential treatment, missed or delayed medical appointments, and
lower health status (Fitzpatrick, Powe, Cooper, Ives, & Robbins, 2004; Goodwin,
Hunt, & Samet, 1993; Gwira et al., 2006; Horton & Johnson, 2010; Okoro,
Strine, Young, Balluz, & Mokdad, 2005; Rittner & Kirk, 1995).
Transportation has been recognized as a key ele- ment of health care
access, which highlights its role to offset long-term health consequences.
Delayed medical care may adversely affect patients' quality of life and
result in more depressive symptoms (Owsley et al., 2007). These delays can
also lead to an increased need for emergency care and pre- ventable
hospitalizations and result in higher medical costs (Hughes-Cromwich &
Wallace, 2006; Rust et al., 2008).
Approximately 3.6 million adults miss or delay non- emergency medical care
due to transportation barriers (Hughes-Cromwich & Wallace, 2006). The
population missing these visits may be particularly susceptible to poorer
health status and higher cost of care. These transpor- tation barriers are
more likely to influence older individu- als, females, minorities, and
those with lower income levels (Hughes-Cromwich & Wallace, 2006; U.S.
Government Accountability Office, 2003). Medicaid acknowledges the
importance of transportation for vulnerable populations and the associated
potential costs of delayed medical care (Kim, Norton, & Stearns, 2009). In
fact, federal Medicaid requires that states "ensure necessary
transportation for recipients to and from providers" to help meet the needs
of this population and the intent of Medicaid (The Hilltop Institute, 2008
).
Bellamy,G. R., Stone,K., Richardson,S. K., & Goldsteen,R. L. (2003).
Getting from here to there: Evaluating West Virginia's rural nonemergency
medical transportation program. Journal of Rural Health, 19(Suppl),
397-406.
Community Transportation Association of America. (2008). Federal Register,
73, 245. http://web1.ctaa.org/webmodules/webarticles/
articlefiles/cms1219.pdf<http://web1.ctaa.org/webmodules/webarticles/articlefiles/cms1219.pdf>
.
Community Transportation Association of America. (2009). America's
Affordable Health Choices Act of 2009. http://
www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_
BillText_071409.pdf<http://www.ctaa.org/webmodules/webarticles/articlefiles/AAHCA_BillText_0714…>.
Community Transportation Association of America. (2010). An overview: How
health care reform impacts community and public transportation.
http://web1.ctaa.org/webmodules/webar-
ticles/anmviewer.asp?a=1672&z=5<http://web1.ctaa.org/webmodules/webar-ticles/anmviewer.asp?a=1672&z=5>.
Fitzpatrick,A. L., Powe,N. R., Cooper,L. S., Ives,D. G., & Robbins,J. A.
(2004). Barriers to health care access among the elderly and who perceives
them. American Journal of Public Health, 94, 1788-1794.
http://dx.doi.org/10.2105/AJPH.94.10.1788.
Goodwin,J. S., Hunt,W. C., & Samet,J. M. (1993). Determinants of cancer
therapy in elderly patients. Cancer, 72, 594-601.
Gwira,J. A., Vistamehr,S., Shelsta,H., Bashford,K., Forster,S.,
Palmisano,P., Shafranov,G., & Shields,M. B. (2006). Factors associated with
failure to follow up after glaucoma screening: a study in an African
American population. Ophthalmology, 113, 1315-1319.
http://dx.doi.org/10.1016/j.ophtha.2006.04.017
Horton,S., & Johnson,R. J. (2010). Improving access to health care for
uninsured elderly patients. Public Health Nursing, 27, 362- 370.
doi:10.1111/j.1525-1446.2010.00866.x
Hughes-Cromwich,P. & Wallace,R. (2006). Cost benefit analy- sis of
providing non-emergency medical transportation. Transportation Research
Record: Journal of the Transportation Research Board, 1956, 86-93.
doi:10.3141/1956-11
Kim,J., Norton,E. C., & Stearns,S. C. (2009). Transportation brokerage
services and Medicaid beneficiaries' access to care. Health Services
Research, 44, 145-161. doi:10.1111/j.1475-6773.2008.00907.x
Leduc,N., Tannenbaum,T. N., Bergman,H., Champagne,F., Clarfield,A. M., &
Kogan,S. (1998). Compliance of frail elderly with health services
prescribed at discharge from an acute-care geriatric ward. Medical Care, 36,
904-914. doi:10.1097/00005650-199806000-00013
Leutz,W., & Capitman,J. (2007). Met needs and unmet needs, and satisfaction
among Social HMO members. Journal of Aging & Social Policy, 19, 1-19.
doi:10.1300/J031v19n01_01
Lynott,J., Fox-Grage,W., & Guzman,S. (2013). Weaving it together: A
tapestry of transportation funding for older adults. AARP Public Policy
Institute. http://www.aarp.org/research/ppi/liv-
com2/policy/transportation/articles/weaving-it-together-trans-
portation-funding-for-older-adults-AARP-ppi-liv-com.html<http://www.aarp.org/research/ppi/liv-com2/policy/transportation/articles/we…>
Nasvadi,G. E. & Wister,A. V. (2006). Informal social support and use of a
specialized transportation system by chronically ill older adults. Environment
and Behavior, 38, 209-225. doi:10.1177/0013916505277605
Owsley,C., McGwin,G. Jr, Scilley,K., Meek,G. C., Seker,D., & Dyer,A.
(2007). Effect of refractive error correction on health-related quality of
life and depression in older nursing home residents. Archives of
Ophthalmology, 125, 1471-1477. doi:10.1001/ archopht.125.11.1471
Rittner,B., & Kirk,A. B. (1995). Health care and public transpor- tation
use by poor and frail elderly people. Social Work, 40, 365-373.
http://search.proquest.com/docview/1297015299?acc
ountid=14496 <http://search.proquest.com/docview/1297015299?accountid=14496>
Rust,G., Ye,J., Baltrus,P., Daniels,E., Adesunloye,B., & Fryer,G. E.
(2008). Practical barriers to timely primary care access: Impact on adult
use of emergency department services. Archives of Internal Medicine, 168,
1705-1710. doi:10.1001/ archinte.168.15.1705
The Hilltop Institute. (2008). Non-Emergency Medical Transportation (NEMT)
Study Report. http://www.hilltopinsti-tute.org/publications/Non-EmergencyMedicalTransportationSt
udyReport-September2008.pdf<http://tute.org/publications/Non-EmergencyMedicalTransportationStudyReport-…>.
Whittier,S., Scharlach,A. E., & Dal Santo,T. S. (2005). Availability of
caregiver support services: Implications for implementation of the National
Family Caregiver Support Program. Journal of Aging and Social Policy, 17,
45-62. doi:10.1300/J031v17n01_03
Yeatts,D. E., Crow,T., & Folts,E. (1992). Service use among low- income
minority elderly: Strategies for overcoming barriers. The Gerontologist, 32,
24-32. doi:10.1093/geront/32.1.24
On Sat, Mar 1, 2014 at 10:00 AM, <h+t--friends-request(a)chrispy.net> wrote:
> Send H+T--Friends mailing list submissions to
> h+t--friends(a)chrispy.net
>
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>
> When replying, please edit your Subject line so it is more specific
> than "Re: Contents of H+T--Friends digest..."
>
>
> Today's Topics:
>
> 1. Access to Health Care (Ed Christopher)
> 2. Re: Access to Health Care (Rajiv Bhatia)
> 3. Re: Access to Health Care (denita Jones)
> 4. Re: Access to Health Care (Rajiv Bhatia)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Fri, 28 Feb 2014 14:43:16 -0600
> From: Ed Christopher <edc(a)berwyned.com>
> Subject: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID: <5310F4E4.9060008(a)berwyned.com>
> Content-Type: text/plain; charset=ISO-8859-1; format=flowed
>
> I got asked a question today, from a transportation perspective,
> about access to health care and health facilities. As I started to hunt
> around on the web I thought I would throw it out to our Listserve. Does
> anyone know of any research, literature or other articles that they
> could pass along dealing with access to health care services?
>
> Thanks
> --
> Ed Christopher
>
>
> ------------------------------
>
> Message: 2
> Date: Fri, 28 Feb 2014 13:13:39 -0800
> From: Rajiv Bhatia <rb6419(a)gmail.com>
> Subject: Re: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID: <73BF7334-5E7C-4BC7-8B00-1C6139B8B486(a)gmail.com>
> Content-Type: text/plain; charset=us-ascii
>
> There is limited information on this topic. I did a review of this and
> other EJ impacts for EPA a few years ago.
>
> A few studies have looked at transport access to facilities and their
> association to health outcomes. Most studies treated the "exposure
> variable" as auto ownership. Net conclusion is that auto owners have
> better access to health facilities. THere is a very limited association
> to health outcomes.
>
> I would not take this as a null result -- just one that has been
> understudied.
>
> Rajiv
>
>
>
> On Feb 28, 2014, at 12:43 PM, Ed Christopher <edc(a)berwyned.com> wrote:
>
> > I got asked a question today, from a transportation perspective,
> > about access to health care and health facilities. As I started to hunt
> > around on the web I thought I would throw it out to our Listserve. Does
> > anyone know of any research, literature or other articles that they
> > could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
>
>
>
>
> ------------------------------
>
> Message: 3
> Date: Fri, 28 Feb 2014 15:12:18 -0600
> From: denita Jones <denita944(a)gmail.com>
> Subject: Re: [H+T--Friends] Access to Health Care
> To: TRB Health and Transportation <h+t--friends(a)chrispy.net>
> Message-ID:
> <CAKZGZAxDq9_5x+JQrc_Z3oL5oFe5yYaE4zKh=
> 5vJ7_jHgdNnmA(a)mail.gmail.com>
> Content-Type: text/plain; charset="iso-8859-1"
>
> Im actually presenting research in that area in DC next month. I'm not in a
> position now to give the names of articles (im driving) But I can send them
> to you and suggest sites.
> On Feb 28, 2014 3:07 PM, "Ed Christopher" <edc(a)berwyned.com> wrote:
>
> > I got asked a question today, from a transportation perspective,
> > about access to health care and health facilities. As I started to hunt
> > around on the web I thought I would throw it out to our Listserve. Does
> > anyone know of any research, literature or other articles that they
> > could pass along dealing with access to health care services?
> >
> > Thanks
> > --
> > Ed Christopher
> > _______________________________________________
> > H+T--Friends mailing list
> > H+T--Friends(a)chrispy.net
> > https://www.chrispy.net/mailman/listinfo/h+t--friends
> >
>
I got asked a question today, from a transportation perspective,
about access to health care and health facilities. As I started to hunt
around on the web I thought I would throw it out to our Listserve. Does
anyone know of any research, literature or other articles that they
could pass along dealing with access to health care services?
Thanks
--
Ed Christopher