The Impact of Transportation Disadvantage on Healthcare Access.
Millions of Americans have difficulties in transporting themselves to desired locations and thus are considered to be transportation disadvantaged (Wallace, Hughes-Cromwick, Mull, & Khasnabis, 2005). This population group is found to participate in fewer out-of-home activities, which may eventually result in social exclusion and impaired well-being (Kenyon, Rafferty, & Lyons, 2003; Marottoli et al., 2000). This research examines one critical aspect that is important for people’s well-being—healthcare access. Despite the effort and resources the government has put into improving healthcare access, impaired access remains a problem in the United States (Department of Health and Human Services, 2010). Transportation disadvantage has been reported as one key barrier to healthcare access (Arcury, Preisser, Gesler, & Powers, 2005).
Building on social exclusion theory, this dissertation examines the impact of transportation disadvantage, including limited mobility due to a lack of access to transportation resources and long travel times to usual source of care, on healthcare access among non-institutionalized adults in the United States with the use of secondary data from the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS), two national surveys that report on healthcare access, health status, healthcare expenditure, and other health-related information.
To be more specific, I use data from the NHIS 1993-1996 to examine the impact of vehicle ownership on healthcare access, which is measured by whether or not one has a usual place that is not a hospital emergency department (ED) for medical care, and whether or not one has forgone needed medical care in the last 12 months. Those who have no vehicle in the family are considered to be transportation disadvantaged. By using logistic regression models to perform cross-sectional analysis, this study finds that owning a vehicle in the family is associated with higher odds of having a non-ED place for usual source of care and with lower odds of having forgone needed medical care, when demographic, socio-economic and health characteristics are controlled for. I also use data from Panel 5 of the MEPS 2000-2001 to examine the impact of transportation mode (including driving or being offered a ride, using public transit, and walking) on the likelihood of any family member having difficulties in obtaining needed care. Random-effects logistic regression is used to perform longitudinal data analysis. The results show that having access to a car and having access to public transit are associated with decreased odds of any family member having experienced difficulty in getting care. But no significant difference is found between car users and public transit users.
The above three analyses also include the “metropolitan residence” (i.e., whether a person lives in a Metropolitan Statistical Area, in the central city or not, or does not live in an MSA). Given the assumption that healthcare resources are widely…
Advisors/Committee Members: Eric A. Morris, William C. Bridges, Luis E. Ramos-Santiago, Lu Shi.
to Zotero / EndNote / Reference
APA (6th Edition):
Zhou, Y. (2019). The Impact of Transportation Disadvantage on Healthcare Access. (Doctoral Dissertation). Clemson University. Retrieved from https://tigerprints.clemson.edu/all_dissertations/2520
Chicago Manual of Style (16th Edition):
Zhou, Ying. “The Impact of Transportation Disadvantage on Healthcare Access.” 2019. Doctoral Dissertation, Clemson University. Accessed January 24, 2020.
MLA Handbook (7th Edition):
Zhou, Ying. “The Impact of Transportation Disadvantage on Healthcare Access.” 2019. Web. 24 Jan 2020.
Zhou Y. The Impact of Transportation Disadvantage on Healthcare Access. [Internet] [Doctoral dissertation]. Clemson University; 2019. [cited 2020 Jan 24].
Available from: https://tigerprints.clemson.edu/all_dissertations/2520.
Council of Science Editors:
Zhou Y. The Impact of Transportation Disadvantage on Healthcare Access. [Doctoral Dissertation]. Clemson University; 2019. Available from: https://tigerprints.clemson.edu/all_dissertations/2520