(95) Highway to Healthcare: Screening Patients at Fresno Children's Pediatrics Clinic for Transportation Insecurity

Background: Transportation insecurity in the context of healthcare is when a person is unable to get to where they need to go in order to meet their healthcare needs. Children and adolescents are especially vulnerable to this condition, particularly in regions with limited transportation infrastructure like in California’s Central Valley.

Objectives: This study aimed to identify children with unmet transportation needs at Fresno Children’s Pediatrics Clinic and understand the demographics of affected families to inform targeted interventions.

Design/Methods: We created a screening questionnaire based on the validated Transportation Security Index (TSI) survey developed by researchers at the University of Michigan. We administered these surveys to 100 families who came to Fresno Children’s Pediatrics Clinic for their appointments. The surveys were then scored by the researchers and classified as either “no insecurity/secure”, “marginal/low insecurity” and “moderate/high insecurity”.

Results: Out of the 100 families that were screened, 2% of families were classified in the “moderate/high insecurity” category and 10% in the “marginal/low insecurity” category. The demographics in the “moderate/high insecurity” group consisted of all female patients who were Hispanic and were between 0-2 years old. 50% of families in this group had an average household income of <$30,000 while the other 50% is unknown. Only 50% of participants had a person in the primary household with a valid driver’s license and these families reported traveling an average of 5-15+ miles to get to clinic. In the “marginal/low insecurity” group, patients were equally split between males and females. 80% of patients were between 0-12 years old. 50% identified as Hispanic, 90% had Medi-Cal/CHIP and the average household income ranged from <$30,000-60,000 for 70% of participants. The number of people in the primary household with a valid driver’s license ranged from 0 to 2. The number of miles participants had to travel to get to clinic was between < 5 to 15 miles.

Conclusions: Transportation insecurity is present amongst the pediatric population at Fresno Children’s Pediatric Clinic in varying degrees but especially amongst children of minorities. The lack of transportation can affect a child’s ability to get vital healthcare, which can lead to healthcare disparities. More research is needed on transportation insecurity for the pediatric population so that solutions can be found to close healthcare gaps.