Investigating the Relationship Among Transportation Disparities, Race, Gender, and COVID-19 Health Effects

Overview: COVID-19 has highlighted social, economic, and environmental disparities, including transportation access. Limited transportation may mean reduced access to healthcare and social supports among marginalized groups. The current study investigates how transportation disparities relate to the impact of COVID-19 on physical and mental health among persons disproportionately at-risk for transportation disadvantage.Proposal text:

Background: COVID-19 has highlighted social, economic, and environmental disparities in communities, including access to transportation. Individuals lacking access to their own cars, who are disproportionately lower income and minority race, have experienced greater risk of COVID-19 infection and death (Stokes et al., 2020). Limited transportation resources may mean that they have had less access to reliable healthcare (Syed et al., 2013) and social support (Fields et al., 2019), both of which have been essential to personal resilience during the pandemic. The current study investigates how disparities in transportation resources relate to the impact of COVID-19 on physical and mental health among a diverse sample of persons with disproportionately high rates of transportation disadvantage, Moreover, given disparities in COVID-19 and transportation access, we tested for race and gender effects.

Methodology: We collected data, in the form of an online survey, related to transportation, mobility, health, and COVID-19 in three states across a diverse sample of persons disproportionately at-risk for reduced access to transportation resources (Nf111, 68% female, 34% African American, 9% Hispanic/Latinx). Participants were recruited through community partners and online media across the fall, 2021, and winter, 2022. Two survey items asked about self-reported effects of COVID-19 on mental health and physical health; responses were dichotomized as “not at all or moderately” or “somewhat to a lot”. Following bivariate analyses, both items were regressed on gender (male/female), race/ethnicity (African American/Black, White, Hispanic/Latinx, Other), participants’ number one preferred way to travel (car, 43%; public transit, 28%; other, 29%), and car ownership (yes, 41%), using two multivariate, binomial logistic regression models.

Results: Overall, 54% of participants reported that COVID-19 negatively impacted their physical health; 65% reported negative mental health effects. The regression model for physical health effects was non-significant. The regression model for mental health effects was statistically significant (Likelihood ratio chi-square = 16.809 (df=7), p=.019), and being female compared to male (Exp(B) = 4.252) and reporting a car as one’s number one preferred form of transportation versus other types (Exp(B) =6.991) predicted higher odds of negative mental health impacts due to COVID-19.

Conclusion: Among this diverse sample, COVID-19 showed negative effects for mental health among females and persons reporting car as their number one form preferred form of transportation. Potential interactions between transportation and gender as they predict mental health risks is an area for future research, particularly as it relates to people’s abilities to get out of the house and engage with others. One possible explanation is that higher rates of caregiving among females, compared to males, correlate with greater social engagement and support, as well as a greater need for on-demand transportation; thus, the community-wide lockdowns and isolation of COVID-19 could have placed them at higher risk for mental distress. At a practical level, these preliminary findings indicate that community-service organizations may help to mitigate the negative impact of COVID-19 by assessing clients for transportation resources and providing expanded funding and transportation services in under-served communities.