When Transportation Becomes a Health Barrier

Getting care still requires getting there.

Think about the last time you made a doctor’s appointment. Maybe you scheduled it weeks in advance, rearranged your workday, made arrangements for your children. When the day came, you got in the car and went.

Now imagine doing all of that without knowing for certain whether you’ll actually be able to get there.

When a missed bus becomes a missed appointment

During a recent NEPA Moves conversation about transportation, participants talked about the additional planning that can come with something as basic, and as important, as taking care of their health. One participant described trying to get to a dental appointment using public transportation. What should have been a trip to receive care turned into nearly three hours spent navigating transportation, and the appointment had to be canceled. The health need hadn’t gone away. Now another appointment had to be scheduled, another day set aside, transportation figured out again, possibly another conversation with an employer. And then they had to try again.

Another participant talked about using paid time off for medical appointments and the uncertainty that comes when transportation doesn’t arrive as expected. For someone who drives, running late might mean calling the office from the car and hoping to still be seen. For someone relying on public transportation, a disruption can mean there isn’t another option coming soon enough to make the appointment at all. A missed bus can become a missed appointment. A missed appointment can become delayed care.

When health needs don’t wait

Health needs don’t always give notice. A child wakes up sick. A doctor calls with a same-day cancellation. A prescription needs picking up before the pharmacy closes. For someone with a car outside, these moments are stressful, but transportation itself usually isn’t the first problem to solve. For someone without one, it often is: is there a bus running now, does it go where you need, can you get home afterward, and if not, who can you call?

Reliability also means something different depending on what’s waiting at the other end of the trip. If it’s an appointment you’ve waited weeks for, or PTO you can’t get back, or recurring treatment you’ll have to navigate again next week, a late or missed bus isn’t just an inconvenience.

The step between availability and care

Communities invest significant resources in healthcare: insurance, providers, expanded services, reminders not to put off care. But there’s a step between having healthcare available and receiving it. You have to get there. For those of us who drive, that step can be so automatic we barely recognize it as part of the equation. For many of our neighbors, there are several more steps between making the appointment and walking through the door. Healthcare access doesn’t begin at the office. It begins with whether someone has a realistic, reliable way to reach it.

The panel conversation also included information from Transit for All PA about Week Without Driving PA, a statewide initiative taking place October 1–8. To learn more and explore how you can participate in WWD PA, visit weekwithoutdrivingpa.org.