Transportation Justice and Health

Transportation as a Social Determinant of Health

The health care sector is increasingly investing in social conditions to improve health care utilization and outcomes.^1–4 Under the umbrella of social determinants of health, advocates, researchers, and policymakers have shifted attention upstream to better understand the mechanisms and potential interventions to address social risk (e.g., housing insecurity, poverty, lack of education and employment opportunities, food insecurity) to improve health and well-being and ameliorate long-standing inequities.

Transportation is one of these core social determinants and yet the understanding of transportation in health care has heavily focused on a limited view of transportation insecurity rather than adopting the more inclusive approach of transportation justice. Transportation justice “describes a normative condition in which no person or group is disadvantaged by a lack of access to the opportunities they need to lead a meaningful and dignified life”.⁵ In this perspective, we will characterize the existing research investigating transportation as a social determinant of health and propose applying a more holistic transportation justice framework to systemic problems in health care including two case examples.

References

1. Wilson BG, Jones E. Lessons on increasing racial and health equity from ac-countable health communities. J Healthc Qual. 2022;44(5):276-285. https://doi.org/10.1097/jhq.0000000000000356.
2. Kulkarni A, Davey-Rothwell M, Mossialos E. Accelerating integration of social needs into mainstream healthcare to achieve health equity in the COVID-19 era. Health Econ Policy Law. 2023;18(1):82-87. https://doi.org/10.1017/s1744133122000172
3. Byhoff E, Gottlieb LM. When there is value in asking: an argument for social risk screening in clinical practice.Ann Intern Med. 2022;175(8):1181-1182.https://doi.org/10.7326/m22-0147
4. National Academies of Sciences, Engineering, and Medicine. Integrating social needs care into the delivery of health care to improve the nation’s health. September 2019. Accessed July 26, 2023.https://www.nationalacademies.org/our-work/integrating-social-needs-care-into-the-delivery-of-health-care-to-improve-the-nations-health
5. Karner A, London J, Rowangould D, Manaugh K. From transportation equity to transportation justice: within, through, and beyond the state .J Plann Lit.2020;35(4):440-459. https://doi.org/10.1177/0885412220927691vvv