Breaking Barriers: Addressing Transportation Challenges and Healthcare Access for Expectant Mothers in Impoverished Communities
Submitted by Muhammed F. Aljerari
Tags: health care systems health disparities mother pregnancy Transport and Relief
The impoverished people in rural areas and remote communities often face significant challenges that hinder their ability to seek professional healthcare. One of these challenges is the ability to access a reliable mode of transportation to a nearby city or urban area where healthcare would be available (Syed et a1., 2013). This is important because clinics and hospitals are often concentrated in urban and metropolitan environments and these areas can be quite distant for people living in remote communities. This is especially critical for women and pregnant women as seeing a women's health provider is important to staying healthy. Seeing a healthcare provider for routine check ups is very important for pregnant women, it could help catch early complications that would typically be a problem later on in the patient's pregnancy (Mohseni et al., 2023). One example of such a complication could be a congenital deformation that could be detected early in pregnancy. A lack of reliable transportation for women living in rural communities could impact their health during pregnancy. This is a global problem that clinicians and healthcare providers must help solve. Millions of women internationally not receiving prenatal care is a cause for concern. Millions of potential complications place unnecessary stress on the already overburdened healthcare systems worldwide (Mohseni et a1., 2023).
Understanding Social Determinants of Health is crucial to uplifting and advocating for patients.An important role of a Registered Nurse is to advocate for patients and to be there for them. As defined by Healthy People 2030, social determinants of health are the conditions in which people live, work and thrive. These factors all contribute to health outcomes and quality of life. A critical social determinant of health often not covered or addressed is healthcare access and quality. Access to healthcare connects to the importance of transportation, for many people healthcare is inaccessible due to a lack of transportation. A lack of a reliable mode of transportation for pregnant women living in an impoverished rural community is detrimental to the patients health and to the neonates health. A study by Denise Holcomb and colleagues concluded that a lack of reliable transportation for pregnant women had negative impacts on the health of the women and the infants (Holcomb et a1., 2021).
Geographical barriers preventing access to prenatal care for expecting mothers can lead to negative health outcomes for the mother and child. Better access to prenatal care leads to better health outcomes for the mother and child and lower rates of preterm birth. Maternal and neonatal research data were obtained from electronic health records and a community-wide data initiative data set. Women who were unable to receive prenatal care had higher rates of substance abuse and higher rates of preterm birth. It was noted that women without access to prenatal care relied on public transportation more than the women who did have access to prenatal care. This shows the effects of poverty on neonatal outcomes (Holcomb et a1., 2021). Women are typically the primary decision makers for healthcare in a family. Therefore a strong push for focusing on women's health can help all populations at a profound level. Women are more impacted by poverty regarding their access to healthcare. Improving the health of women and access to healthcare is a public health matter and is important to improving the healthcare system as a whole. Affordable quality healthcare provided by the government can improve access to healthcare not just for women but for every population. This shows the importance of women's health and how improving healthcare access for women is important to everyone as it will benefit the entire population (Glynn et a1., 2016).
Barriers in transportation are often seen as barriers in healthcare access. As defined by Healthy People 2030, barriers in transportation and healthcare access encompass multiple social determinants of health. A lack of transportation leads to missed appointments and doctors visits, thus leaving the door open for possible health complications that could have been detected by a check up. Regular appointments with a healthcare provider is critical for an expectant mothers health. These problems affect people from every facet of society, regular visits with a healthcare provider is crucial for cancer patients as a missed treatment leaves room for the cancer to grow and spread. 60 percent of Hispanics identified transportation access as an obstacle that could result in missing cancer treatment appointments. A study taken in Atlanta has shown that patients who did not use private transportation were much more likely to delay care and miss appointments. This shows the importance of transportation in terms of healthcare access and how it affects everyone, not just women (Syed et a1., 2013). Prenatal care is important for expectant mothers and is crucial to the health of the mother and to the child. Millions of women around the world do not receive the necessary prenatal care that they should be receiving. A lack of prenatal care for expectant mothers has led to over a million babies dying after birth every year. Internationally, 1 in 10 babies are born prematurely, leading to many challenges for clinicians and healthcare providers. This shows how the lack of prenatal care for expectant mothers is a global problem that needs to be tackled (Mohseni et a1., 2023). In the United States lack of prenatal care is a serious problem for impoverished rural and urban communities. As mentioned earlier, lack of prenatal care has detrimental effects on the expectant mother and the neonate. Impoverished communities that lack the resources to access prenatal care and healthcare are more susceptible to preventable deaths.
A study conducted by Modde explores how low income pregnant women experience their pregnancy and the importance of their health in relation to it. In this study twenty pregnant women who are single and of low income background were recruited from an urban women's health clinic and were individually interviewed towards the end of their pregnancies. This study has shown that most women feel being financially stable and being supported were very important to them as expectant mothers. Adequate financial and social resources were seen as being crucial to a healthy pregnancy. This connects to Healthy People 2030s definition of social determinants of health, as economic stability is a major factor as a social determinant of health. Economic stability connects to the ability to access private transportation. Automobiles are very expensive and many people cannot afford to drive one. This shows a low income expectant mothers perspective on how access to healthcare and a reliable mode of transportation is important. A personal account from these women is important because oftentimes these women may not feel like they are heard or are given a voice (Modde et a1., 2023).
The role of the Registered Nurse involves advocating for the patient and seeking to improve their situation. This is why understanding the social determinants of health as defined by Healthy People 2030 is crucial. Understanding social determinants of health is critical to uplifting and advocating for patients. As defined by Healthy People 2030, social determinants of health are the conditions in which people live, work and thrive. These factors all contribute to health outcomes and quality of life. An important social determinant of health ofien not covered or addressed is healthcare access and quality. Access to healthcare connects to the importance of transportation, for many people healthcare is inaccessible due to a lack of transportation. Millions of women internationally not receiving prenatal care is a cause for concern. Millions of potential complications place unnecessary stress on the already overburdened healthcare systems worldwide (Mohseni et a1., 2023).
Beyond being an international problem, this is also a human issue. It's unfortunate that right now many mothers are expecting a child and are unable to access the necessary healthcare to safely deliver the child. In conclusion, awareness of social determinants of health, specifically healthcare access, must be an important factor to consider for clinicians and healthcare providers when dealing with patients in rural and impoverished communities.
References
- Glynn A, MacKenzie R, Fitzgerald T. Taming Healthcare Costs: Promise and Pitfalls for Women's Health. J Womens Health (Larchmt). 2016 Feb;25(2): 110-6. doi: 10.1089/jwh.2015.5295. Epub 2015 Oct 21. PMID: 26488183; PMCID: PMC4761820.
- Holcomb, D. S., Pengetnze, Y., Steele, A., Karam, A., Spong, C., & Nelson, D. B. (2021).
- Geographic barriers to prenatal care access and their consequences. American Journal of Obstetrics & Gynecology MFM, I(5), 100442.
- Modde Epstein C, Houfek JF, Jones LP. Deep health: A qualitative, woman-centered perspective of health during pregnancy. Midwifery. 2023 May;120:103628. doi: 10.1016/j.midw.2023.103628. Epub 2023 Feb 19. PMID: 36870255; PMCID: PMC10111285.
- Mohseni M, Mousavi Isfahani H, Moosavi A, Dehghanpour Mohammadian E, Mirmohammadi F, Ghazanfari F, Ahmadi S. Health system-related barriers to prenatal care management in low- and middle-income countries: a systematic review of the qualitative literature. Prim Health Care Res Dev. 2023 Feb 27;24:e15. doi: 10.1017/S1463423622000706. PMID: 36843095; PMCID: PMC9972358.
- Syed ST, Gerber BS, Sharp LK. Traveling towards disease: transportation barriers to health care access. J Community Health. 2013 Oct;38(5):976-93. doi: 10.1007/s10900-013-9681-1. PMID: 23543372; PMCID: PMC4265215.