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The most important part of a doctor’s appointment? Getting there.
By Mark Pabst
Eating right, getting enough sleep and exercising are all important to your overall health and well-being. But so is your zip code. In fact, research shows that up to 60% of your health is determined by where you live, work and play.
One way is through a lack of access to reliable transportation. Take, for example, the many Medicaid recipients who don’t own a car, don’t have neighbors or friends who can loan them a car, and live in an area with few public transportation options. Though they have excellent health benefits through Medicaid, they have limited means of accessing those benefits.
That’s one reason Aetna Better Health provides access to care by covering no-cost, curb-to-curb transportation for members using a shared car, taxi, bus, or other public or private means to get to their medical appointment for plan-covered medical services. The program also includes mileage reimbursement, so people with a vehicle can afford the gas and maintenance associated with traveling to and from an appointment.
And, because a healthy lifestyle involves more than just trips to see your doctor, Aetna is also looking into ways to provide transportation that increases members’ well-being beyond the clinical setting. Work is already under way in some states. For example, “Aetna Better Health of California (ABHCA) is currently exploring ways to address even more of our members’ barriers to good health by providing additional no-cost rides to places like grocery stores, workforce development offices, libraries and shelters," explains Jill Webber, MPH, cultural and health equity director and health educator for ABHCA.
But as the graphic below illustrates, transportation is a complex issue that can’t be addressed by a single entity, especially in a state as large as California. Everyone from policymakers to local transit authorities to health insurers must work to ensure that Medicaid members have access to reliable transportation. By working together to provide help with everything from sufficient infrastructure to making sure low-cost transit options exist in every community, we can offer a crucial link to health for some of our nation’s most vulnerable residents.
How does better transportation translate into better health?
Aetna knows transportation availability, cost and time can prevent members from getting medical care in a timely and efficient way.
1 in 4 people miss appointments due to transportation problems.1
That’s one reason why, in its first 21 months, Aetna’s transportation program provided nearly 1,100 rides to Medi-Cal members. And we’re hoping to expand our program to where people need it most.
Counties with limited transportation often have higher-than-average Medi-Cal populations.
Percentage of the population eligible for Medi-Cal benefits2
51% Imperial County
50% Fresno County
41% San Bernardino County
35% State of California
Residents of certain counties are less likely to have access to private transportation.
Percentage of households with no car
California average (minus San Francisco and Los Angeles counties)3
San Bernardino County4
Imperial County5
Fresno County6
And these counties also have limited public transportation.
Rank in public transportation score among California’s 58 counties7
31st Imperial County
23rd Fresno County
12th San Bernardino County
1st San Francisco County
Unfortunately, these same counties also have heavy burdens of chronic disease.
Obesity prevalence8
Fresno County 28.5%
San Bernardino County 26%
Imperial County 27.3%
State of California 22.6%
Diabetes prevalence9
Fresno Country 9.8%
San Bernardino County 8.9%
Imperial County 7.7%
State of California 8.1%
People without access to a car are
44% less likely to have a primary care provider.10
45% more likely to delay chronic conditions.11
Without reliable transportation, people may be forced to miss potentially life-saving care.
Patients without transportation are 7x more likely to miss chemotherapy appointments.12
“Aetna Better Health of California recognizes the importance of accessible, reliable transportation. That’s why we provide no-cost, curb-to-curb transportation to our members with provider or plan approval.” – Jill Webber, MPH Cultural and Health Equity Director and Health Educator, Aetna Better Health of California
1 Silver D, Blustein J, Weitzman BC. Transportation to clinic: Findings from a pilot clinic-basednsurvey of low-income suburbanites. Journal of Immigrant and Minority Health/Center for Minority Public Health. 2012; 14(2):350-355.
3 https://www.usnews.com/news/healthiest-communities/data-explorer
4 Ibid
5 Ibid
6 Ibid
7 https://alltransit.cnt.org/rankings/
8 https://www.usnews.com/news/healthiest-communities/california
9 Ibid
10 https://www.ncbi.nlm.nih.gov/pubmed/8201737
11 Ibid
12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210900/
How does better transportation translate into better health?
Aetna knows transportation availability, cost and time can prevent members from getting medical care in a timely and efficient way.
1 in 4 people miss appointments due to transportation problems.1
That’s one reason why, in its first 21 months, Aetna’s transportation program provided nearly 1,100 rides to Medi-Cal members. And we’re hoping to expand our program to where people need it most.
Counties with limited transportation often have higher-than-average Medi-Cal populations.
Percentage of the population eligible for Medi-Cal benefits2
51% Imperial County
50% Fresno County
41% San Bernardino County
35% State of California
Residents of certain counties are less likely to have access to private transportation.
Percentage of households with no car
California average (minus San Francisco and Los Angeles counties)3
San Bernardino County4
Imperial County5
Fresno County6
And these counties also have limited public transportation.
Rank in public transportation score among California’s 58 counties7
31st Imperial County
23rd Fresno County
12th San Bernardino County
1st San Francisco County
Unfortunately, these same counties also have heavy burdens of chronic disease.
Obesity prevalence8
Fresno County 28.5%
San Bernardino County 26%
Imperial County 27.3%
State of California 22.6%
Diabetes prevalence9
Fresno Country 9.8%
San Bernardino County 8.9%
Imperial County 7.7%
State of California 8.1%
People without access to a car are
44% less likely to have a primary care provider.10
45% more likely to delay chronic conditions.11
Without reliable transportation, people may be forced to miss potentially life-saving care.
Patients without transportation are 7x more likely to miss chemotherapy appointments.12
“Aetna Better Health of California recognizes the importance of accessible, reliable transportation. That’s why we provide no-cost, curb-to-curb transportation to our members with provider or plan approval.” – Jill Webber, MPH Cultural and Health Equity Director and Health Educator, Aetna Better Health of California
1 Silver D, Blustein J, Weitzman BC. Transportation to clinic: Findings from a pilot clinic-basednsurvey of low-income suburbanites. Journal of Immigrant and Minority Health/Center for Minority Public Health. 2012; 14(2):350-355.
3 https://www.usnews.com/news/healthiest-communities/data-explorer
4 Ibid
5 Ibid
6 Ibid
7 https://alltransit.cnt.org/rankings/
8 https://www.usnews.com/news/healthiest-communities/california
9 Ibid
10 https://www.ncbi.nlm.nih.gov/pubmed/8201737
11 Ibid
12 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210900/
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About the author
Mark Pabst has worked as a writer and researcher in the health care field for almost two decades. When not writing about health he tries to stay healthy through activities like hiking, climbing and paddling in the far flung corners of his native state of California. However, despite his best efforts he still has a few unhealthy habits he can’t shake, most notably a weakness for jelly donuts.