Presenting Author: Whitney Cabey, MD, Veterans Administration Scholar, Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania

ABSTRACT

Background: Difficulty accessing healthcare due to inadequate transportation is rarely explored empirically. The availability of healthcare in urban environments may decrease when accounting for public transportation and the socioeconomic factors that predispose to transportation related access barriers.

Objectives: To (1) develop a model of urban public transportation access to healthcare destinations, (2) test for associations between the geographic availability of primary care providers (PCPs) and transportation access in the city of Philadelphia.

Methods: We used US Census data at the block group level to conduct a principal component analysis (PCA). We created composite descriptors of community and demographic factors influencing access and describing transportation use. We used the component scores as predictors in a multivariate regression model of access to PCPs within a 30 minute public transportation ride from each block group centroid.

Results: The unrotated PCA loaded 39 variables into a 5-component model accounting for 54% of the variance. In multivariable regression analysis 3 components were associated with the number of PCPs within 30 minutes of the block group centroid, (adjustedR(2) = 0.4845, p<.001). Component 1 loadings: 18-64 years of age, >bachelors degree, biking/walking to commute; Component 2 loadings: Black race, <high school education, public transportation to commute; Component 3 loadings: Latino ethnicity, <high school education, low income.

Implications: We describe for the first time, baseline transportation characteristics of communities in Philadelphia as they relate to healthcare destinations. This is the first step in the development of a novel approach to exploring a potential barrier in access to care.

Authors: Whitney Cabey, MD; Megan Ryerson, PhD; Rebecca Hubbard, PhD; David Grande, MD, MPA; and Douglas Wiebe, PhD.