Neighborhood-Level Transportation Insecurity Reduces Colorectal Cancer Screening

According to an abstract presented at the American College of Gastroenterology scientific meeting, transportation insecurity is a critical yet often overlooked social determinant of health (SDOH), impacting both individual and public health outcomes.

This study evaluated the association between transportation insecurity and colorectal cancer screening rates across US neighborhoods by linking data from the CDC’s PLACES database and the Agency for Healthcare Research and Quality’s SDOH database. Researchers assessed factors including the proportion of households without vehicle access, workers reliant on public transit, and workers who walk to work, analyzing these against neighborhood-level rates of colorectal cancer screening in adults aged 50-75.

Out of 72,305 neighborhoods, 49,358 met inclusion criteria with complete data. Screening rates varied significantly, with a median of 70.6% and a range from 34% to 88%. Multiple linear regression analysis, controlling for household income and neighborhood population, revealed a significant negative association between lack of vehicle access and colorectal cancer screening rates. Specifically, neighborhoods in the 10th decile for vehicle unavailability had a 0.65% decrease in screening rates compared to those in the 1st decile (p < 0.001). Furthermore, neighborhoods farthest from health clinics saw an amplified negative effect of vehicle unavailability, with a 3.39% reduction in screening rates (p < 0.001). Similar associations were observed for workers commuting by walking.

The findings suggest that higher transportation insecurity correlates with reduced colorectal cancer screening, particularly in areas with limited proximity to health facilities. These results highlight the need for policies that improve healthcare accessibility, potentially through increased local health care availability and by incorporating transportation insecurity assessments in primary care to enhance cancer screening rates.

Reference
Misha G, Utkarsh G, Vinay J, et al. Impact of neighborhood-level transportation insecurity on colorectal cancer screening in the United States. Presented at: American College of Gastroenterology. October 25-30,2024. Philadelphia, PA.