NEMT designed to help underserved supports SDoH, health improvement

Part 1 of 2

Life is movement. Without the ability to get from one place to another, we can’t access the necessities we need to survive: food, clothing, shelter, companionship. It also becomes difficult to get to the resources that are essential in maintaining our health.

While many forms of transportation exist that can help us get where we need to go, not everyone has the means or ability to use them. Low-income Americans may choose not to own a car in favor of using those funds to pay for housing, food or other necessities. Others may require a vehicle to get to work due to a shortage of jobs in the radius they’re able to travel on foot, by bike or public transportation. A different type of challenge exists for people with disabilities who can’t drive.

Non-emergency medical transportation (NEMT) is one way to help people get to and from important healthcare appointments.

NEMT was born out of the passing of several landmark federal laws:

• The Civil Rights Act
• The Social Security Act amendments of 1965, which created Medicaid and Medicare
• The Americans with Disabilities Act of 1990

No matter the barriers to one’s movement, a lack of transportation can affect not only day-to-day activities such as work, school or domestic life, it also impacts access to healthcare, impeding positive health outcomes and potentially exacerbating acute or chronic illnesses.

Transportation and health interwoven

In a recent Eno Center for Transportation article, author Renee Autumn Ray outlines the importance of transportation in supporting positive health outcomes and how the two are interconnected. She also explores the policy and regulatory changes that can be made to help improve health and financial outcomes.

Social determinants of health (SDoH), or the non-medical conditions in which people live that can impact health outcomes, point directly to the positive effect transportation has on health. Transportation access is considered one of the most important factors in maintaining or improving health and wellness because the lack of reliable transportation and its effects are woven into nearly every part of daily life.

“Access to other SDOH such as healthcare, food, and social connections may be improved or inhibited depending on an individual’s ability to travel to them,” Ray writes. Without access to healthcare, new conditions may go unnoticed and preexisting conditions may worsen. This leads to not only more costs for the patient, but also potential negative health outcomes.

At-risk populations

Certain populations are more likely to lack transportation than others. Those most at risk for transportation issues are:

• Older adults
• People with disabilities
• Lower-income people
• People who live in rural areas
• Veterans

While each group has its own set of challenges, each may benefit from:

• Delivery of essential items such as food and medications
• In-home healthcare, including personal care and remote patient monitoring

These solutions can help mitigate several SDoH, such as lack of food, poor nutrition and access to healthcare.

Although these solutions may help combat some of the effects of SDoH, they aren’t all-encompassing. Many patients, however, also require in-office care to maintain their health and prevent negative health outcomes. For these individuals NEMT—in addition to nutritious meals, personal care and remote patient monitoring—can be crucial to long-term health.

In part 2 of this series, we’ll look at the history of NEMT and ideas to overcome challenges faced by the service.