Lack of Transportation Is A Driving Factor Behind Cancer
From hospital visits to support groups to going to see a specialist, cancer patients have a lot of commitments. This, in turn, means a lot of moving around from place to place. Even with a car or other effective means of transport, this can be very hard to do. Rearranging your schedule and constantly driving around is both physically and emotionally draining. But what happens if you don’t have any really effective means of transportation? What happens if you don’t have the freedom to reschedule work or other commitments in order to attend important cancer appointments?
Arranging transportation has proven to be a major barrier to combating cancer. For one, many appointments are incredibly far away, making it so that patients have to carve out large portions of their day just to travel to and from the appointment. Many cancer patients are too weak to drive themselves, which means that they have to coordinate with another person in order to get to their appointment. My mother and grandfather travel to and from the hospital anywhere from one day a week to four days a week. They leave early in the morning and don’t come back until late at night, and by then they are both exhausted from the day’s events. Arranging transportation with another person complicates the situation even further, as you have to ensure that both of your schedules are cleared in order to go.
Another problem posed by long trips is that other commitments are not always flexible. Specialists that patients are referred to can be located several hours away and even require overnight trips and plane rides. However, many people don’t have the capacity to devote large periods of time to travel. Work, family, and other various commitments aren’t always easy to sacrifice. Perhaps the patient is a single parent and the only source of income for their family, and they therefore cannot risk missing any hours at work because their income is so important to keeping the family afloat. Another complicated situation arises if that single parent has young children that are hard to bring along. What if a babysitter is not readily available? These types of choices are not uncommon in the world of cancer patients, and they are major factors in why patients often miss important appointments or treatment sessions. It’s incredibly difficult to choose between two very crucial, urgent commitments.
But even for appointments closer to home, a lack of transportation poses a major challenge. Let’s say the patient does not have access to a car. Perhaps their only mode of transportation is a bike, but their body is aching too much from a blood transfusion and thus it’s not plausible to be biking. Or perhaps the public bus system doesn’t stop very close to where the patient needs to go, requiring the patient to walk for several miles even though their body is not very strong due to treatment. Another possible obstacle with this hypothetical bus situation is the issue of immunity levels. I know right now my grandfather has very low immunity because of his treatments, making it difficult for him to even leave his house. Having to use public transportation is therefore not always possible since it requires being in close proximity to other people and other germs.
There’s also the issue of hospital desserts. In rural areas, hospitals can be few and far between, and it might not be a very easy road to get there. According to an article from the Washington Post, in rural America there are many regions where there is only one doctor for 11,000 square miles. On top of being far away, these hospitals might not have the tools necessary to treat a specific, complicated condition. Approximately 80% of rural U.S. hospitals are considered to be medically underserved. They lack the funding and resources of urban hospitals, causing many to be very basic or even close down. The Washington Post “spotlights communities in Texas — where 159 of the state’s 254 counties have no general surgeons, 121 have no medical specialists, and 35 have no doctors at all.” This means that rural Americans might have to travel long distances for medical attention from a specific type of doctor or even any doctor. This kind of commitment and travel requirements is not feasible for many, leaving them with very little ability to care for their own health. This is true not just of rural America but of many regions throughout the world.
There are also racial disparities in access to transportation. The U.S. government’s National Library of Medicine reports on a study comparing the distance, mode, and perception of transportation to cancer treatment appointments among white, black, and Hispanic cancer patients in Texas. The study found that patients sometimes skipped treatment because of a lack of transportation. The reports of transportation barriers such as distance, access to a car, and availability of another person to drive them to treatment were identified as the most prevalent problems. Black and Hispanic patients were noted as having consistently reported these types of issues. Interestingly, the study also found that white patients often lived further from their treatment center than Black and Hispanic patients. As a whole, this study illustrates how transportation is a very real barrier to cancer treatment, and patients need a more viable mode of transportation and help receiving transportation.
Lack of transportation has repercussions even for those who have not been diagnosed with cancer. A separate National Library of Medicine Study, this time in England, concluded that a lack of transportation dissuades people from going to cancer screenings, such as screenings for breast and cervical cancer. These are incredibly important because these particular cancers need to be caught early for the best outcome, and doing so greatly increases the chances of survival.
The question becomes, how can we provide safe, accessible transportation to all? The answer not only lies in infrastructure, but also in the economy and social systems. Policies need to take all of these underlying factors into account, as providing free transportation is not enough if the patient has small children to take care of. It’s a wide-ranging problem, and it requires a holistic perspective.
Sarina
Works Cited
Wang, Chao. “The Impact of Car Ownership and Public Transport Usage on Cancer Screening Coverage: Empirical Evidence Using a Spatial Analysis in England.” Journal of Transport Geography, Elsevier Ltd, Oct. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091749/.
RJ;, Guidry JJ;Aday LA;Zhang D;Winn. “Transportation as a Barrier to Cancer Treatment.” Cancer Practice, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/9397704/.
Saslow, Eli. “‘Out Here, It’s Just Me’: In the Medical Desert of Rural America, One Doctor for 11,000 Square Miles.” The Washington Post, WP Company, 8 Oct. 2019, https://www.washingtonpost.com/national/out-here-its-just-me/2019/09/28/fa1df9b6-deef-11e9-be96-6adb81821e90_story.html.
“Health Care Deserts: Nearly 80 Percent of Rural U.S. Designated as ‘Medically Underserved’.” Kaiser Health News, 1 Oct. 2019, https://khn.org/morning-breakout/health-care-deserts-nearly-80-percent-of-rural-u-s-designated-as-medically-underserved/.
