Predictors of transportation-related barriers to healthcare access in a North American suburb.

Abstract

To identify predictors of transportation-related barriers to healthcare access in a North American suburb. Data from the 2022 Scarborough Survey were used, comprising n = 528 adults living in Scarborough, which is a subu<rb of Toronto, Canada, recruited through iterative sampling. Log binomial regression models identified demographic, socioeconomic, health and transportation predictors of a composite of: (1) delaying a primary care appointment, (2) missing a primary care appointment or (3) postponing or declining a vaccination due to transportation issues. Of the sampled individuals, 34.5% experienced the outcome. In the multivariable model, younger age (RR = 3.03), disability (RR = 2.60), poor mental health (RR = 1.70) and reliance on public transit (RR = 2.09) were associated with greater risk of experiencing the outcome. Full-time employment, reliance on active travel and reliance on others for transportation were specifically associated with greater risk of experiencing a transportation-related barrier to vaccination. In suburban areas such as Scarborough, transportation-related barriers to healthcare access have a disproportionate impact on groups defined by important demographic, health and transportation-related characteristics. These results corroborate that transportation is an important determinant of health in suburban areas, the absence of which may exacerbate existing inequities among the most vulnerable individuals in a given population.