Inequalities in travel time, cost, risk as cause of persistent social and health inequalities

Abstract

Background: inequalities in travel time, travel cost, and travel risk (ITTRC) can consistently affect access to primary care and social services for disadvantaged and marginalized patients. At the same time, the most disadvantaged patients may face the highest travel time, travel cost, and travel risk due to pre-existing disability, poverty, or other intersectional marginalization. Case Report: to study ITTRC as a confounder which reinforces social and health inequalities, key-informants in the World Health Organization Healthy Cities program, Age-Friendly Cities program, and global EcoCities research initiatives (n=5) were engaged to validate a city planning model towards minimizing ITTRC. A case review of Vancouver, Canada, shows developments which help minimize ITTRC have increased over the last decade, but are not financially-accessible for disadvantaged and marginalized patients. Conclusion: ITTRC can be reduced through city planning, but underlying classism and capitalism must be acknowledged and addressed towards equitable physical access to life opportunities.

Keywords

• City Planning
• Diversity, Equity, Inclusion
• Health Inequalities
• Health Services Accessibility
• Transportation of Patients