Transportation Access to Health Care During the COVID-19 Pandemic: Trends and Implications for Significant Patient Populations and Health Care Needs

Since March 2020, COVID-19 transportation system disruptions have altered how Americans access routine health care. This report examines current knowledge about disparities in transportation and access to health care for people with various health conditions and health care needs. The authors highlight evidence related to end-stage kidney disease, pregnancy, cancer, mental health and substance use, disabilities, multiple chronic conditions, and preventive care to discuss population-specific transportation needs and challenges, COVID-19 health risks, and impacts of transportation system disruption on health outcomes during the pandemic. The report concludes with policy recommendations for how leaders in transportation, public health, and health care can improve transportation access to care during the COVID-19 pandemic.

How is the COVID-19 pandemic shaping transportation access to health care?

The Coronavirus disease 19 (COVID-19) pandemic has disrupted both transportation and health systems. While about 40% of Americans have delayed seeking medical care during the pandemic, it remains unclear to what extent transportation is contributing to missed care. To understand the relationship between transportation and unmet health care needs during the pandemic, this paper synthesizes existing knowledge on transportation patterns and barriers across five types of health care needs. While the literature is limited by the absence of detailed data for trips to health care, key themes emerged across populations and settings. We find that some patients, many of whom already experience transportation disadvantage, likely need extra support during the pandemic to overcome new travel barriers related to changes in public transit or the inability to rely on others for rides. Telemedicine is working as a partial substitute for some visits but cannot fulfill all health care needs, especially for vulnerable groups. Structural inequality during the pandemic has likely compounded health care access barriers for low-income individuals and people of color, who face not only disproportionate health risks, but also greater difficulty in transportation access and heightened economic hardship due to COVID-19. Partnerships between health and transportation systems hold promise for jointly addressing disparities in health- and transportation-related challenges but are largely limited to Medicaid-enrolled patients. Our findings suggest that transportation and health care providers should look for additional strategies to ensure that transportation access is not a reason for delayed medical care during and after the COVID-19 pandemic.