November 24, 2015
Since the fall of 2014, ACE and our partners in the On The Move coalition have been working with community health centers in Boston to explore the connection between health and public transportation. As part of this process, health professionals recognized that better transit service would improve patient access to healthcare.
"The transit justice collaboration with ACE was transformative for our Health Center. Our partnership opened a new space to combine organizing, public health, racial justice language and values that was powerful and shared," said Abigail Ortiz, Director of Community Health Programs at the Southern Jamaica Plain Health Center. "Focusing the goals of the project on the extensive transit organizing done by ACE and its members, rather than re-creating new ones, gave our health center clarity about how we can be most effective in placing our patients' realities at the center of our health equity policy work."
This year, 11 health centers in Dorchester, Roxbury, South Boston, the South End, the Fenway and Jamaica Plain collected more than 1,300 surveys from patients, the majority of whom are people of color.
The survey revealed that two-thirds of patients rely on public transportation to get to appointments, with 47 percent using the bus. Over 60 percent of respondents had missed appointments due to issues with public transportation. But this doesn't affect all people equally: Black patients are 1.25 times more likely than white patients - and Latino patients 1.3 times more likely - to miss or be late to an appointment due to transit reasons.
The surveys also show how displacement creates additional strain and affects the well-being of patients. When rising rents push residents out of gentrifying neighborhoods, patients are often forced to move far away from health care providers. Over 34 percent of survey respondents travel more than 30 minutes to reach their appointments, with many reporting commutes over two hours long.
When public transportation fails, patient health suffers. Missing appointments means that medical concerns can go unchecked and can lead to an increase in chronic hospitalizations and trips to the emergency room. In addition, patients can experience negative health impacts due to the stress of long and difficult commutes.
In EJ communities, exposure to environmental inequities like waste incinerators, power plants and other polluting industries, combined with a dearth of fresh food and green space leads to higher rates of illness and disease. Our communities are more likely to need medical care, and less likely to have reliable access to it.
"It is impossible to avoid the need for organizing and systems change when 60 percent of our patients are missing health care appointments - and work, school and more - due to bus service. This burden is carried overwhelmingly by black and Latino patients," said Abigail.
In September, the results of the survey were shared in a gathering of health care professionals in Boston. Community health centers have joined us to support better public transportation by advocating for a permanent Youth Pass, a tiered fare structure on THE RIDE, improved service on key bus routes used by low-income people of color, and by inviting patients to join our T Riders Union (TRU) to fight for transit justice. Directors of the centers are also pushing for a Racial Justice and Equity Commission in Boston to create equity in all areas of life that impact health outcomes.
Thank you to the Center for Community Health, Education, Research and Service, Codman Square Health Center, Fenway Community Health Center, Harvard Street Neighborhood Health Center, JP Tree of Life/Arbol de Vida, JP Racial Justice and Equity Collaborative, South End Community Health Center, Southern Jamaica Plain Health Center, Kevin Odell of On the Move, and Nashira Baril for your leadership for racial and transit justice and to the Boston Alliance for Community Health for funding this initiative! We look forward to continuing this work together.