Ask anyone about life’s basic needs, and you’ll probably hear about food, shelter, health, and education. And while those are all valid responses, many of us don’t realize how they’re all held together by one thread, transportation.
A lack of reliable transport can rapidly unravel the web of life’s necessities. It starts with missing out on education due to an inability to reach school or college, which hampers employment prospects and earning capacity, leading to challenges in housing, food security and overall health and wellbeing. These challenges are disproportionately faced by black, indigenous, and other people of color (BIPOC) communities, deepening already ingrained structural inequalities of society.
Since 2018, Feonix – Mobility Rising has been dedicated to improving mobility, a facet of public health that is as vital as it is overlooked. Now, a substantial grant award from the National Institutes of Health (NIH), marks a pivotal moment in the Feonix journey.
As the primary federal agency for conducting and supporting medical research, NIH is at the forefront of discovery that can change lives and has recognized Feonix’s groundbreaking work with a $6 million grant to advance health equity in Detroit, Michigan and Dallas, Texas.
A Tale of Two Cities
While Dallas and Detroit differ in geography, economy, and sociocultural history, they’re both linked by the shared disparities in transportation for BIPOC communities.
In the early 20th Century, Detroit was the epicenter of the automotive Industry. The big 3, General Motors, Ford, and Crysler, contributed to the population explosion of 1.85 million people in 1950.
However, with Detroit’s shifting population with the economic times, the irony in the Motor City nickname is stark – with almost a quarter of the now 700,000 residents lacking access to a vehicle. This is felt most in Black communities, who report more than double the transportation barriers compared to White non-Hispanic counterparts. In 2022, Feonix hosted a Telephone Town Hall of over 6,000 Detroit residents. Among the respondents, 22% indicated that they had missed or delayed healthcare appointments due to transportation issues in the past 90 days.
On the surface in Dallas once was a humble frontier mining town, and now a sprawling metropolis of over 1.3 million residents and a major hub for industry, business, start-ups and entrepreneurs.
But the stark reality for many living in Dallas is life below the poverty line, with 84% of impoverished residents coming from BIPOC communities and nearly 47,000 households lacking private transportation.
This gap in mobility access is a critical factor in healthcare disparities, particularly evident in crucial areas like maternal and infant health. Many expectant mothers in Dallas who live in areas dependent on public transport deliver their babies without receiving any prenatal care, contributing to rising maternal and infant mortality rates.
Dallas and Detroit, each with their own unique set of challenges, are ideal locations for new initiatives focused on breaking down barriers to health equity.
NIH ComPASS Program Points a New Way Forward
The NIH ComPASS program, funded through the NIH Common Fund, is a pioneering initiative that empowers community organizations like Feonix – Mobility Rising to lead research projects addressing health inequities. These projects focus on social determinants of health and structural interventions in communities, examining factors like access to healthcare, employment, healthy food, and transportation.
With a budget of approximately $171 million over five years, ComPASS awards grants for community-led research to develop sustainable solutions for health equity. Feonix has been awarded $6 million to set up a community-driven research program, entitled “Reducing Health Disparities through Enhanced Mobility Support & Access”. Most of all, this grant is a major acknowledgement of the need to integrate transportation into the broader healthcare conversation.
The current landscape of transportation services often presents a convoluted maze for those in underserved communities, with no sign of a coordinated national strategy on the horizon. Recognizing this challenge, Feonix, in collaboration with academic powerhouses such as Texas A&M Transportation Institute, University of Michigan, Michigan State University, and Southern Methodist University, has crafted a research initiative to explore the transformative potential of improved mobility on healthcare accessibility and patient outcomes.
Streamlining Transportation with the Transportation Assistance Hub
Central to this research is the deployment of the Transportation Assistance Hub (TAH), an intervention designed to declutter the complex web of transport services and enhance healthcare access. The TAH introduces a ‘mobility wallet’—a personalized fund within reach of patients for their healthcare-related journeys. Whether it’s catching an Uber to the doctor’s office, using public transit to fill a prescription, or navigating to other health-related errands, the mobility wallet provides individual freedom to choose the most convenient transport mode. To complement this system is the role of the Mobility Navigator—a personal guide offering tailored support to help patients efficiently plan their travel and maximize their transportation funds.
Patient-Centered Control in Transportation
Valerie Lefler, Executive Director of Feonix Mobility Rising, emphasizes the pivotal shift towards patient empowerment through the TAH. “One of the important distinctions about this program is that the individual is in control of the transportation,” notes Lefler. “Traditionally, Medicaid, Medicare and others arrange for transportation through a broker. Historically, that has not been super effective.”
The TAH model with a mobility wallet and mobility navigator guide is vastly different from existing ones as it allows individuals to take control of the booking process themselves. This is important, as traditional broker systems often come with various hurdles and complications, making the process of booking a ride feel like a game of broken telephone. Some of the challenges with this traditional system include issues with the accuracy of residential addresses, pick-up times for trips, and making sure the transportation provided is reliable and arrives on time.
In its place, the TAH offers a seamless, user-friendly platform that includes a smartphone app, web portal, and call center, all designed to streamline the process of selecting and booking tailored transportation at short notice and in real-time.
Impact and Sustainability
Feonix’s research goes beyond the surface, diving deep into the impact of transportation on healthcare utilization. By meticulously tracking how individuals’ use of health facilities evolves after receiving transportation support, the study seeks to uncover whether increased autonomy in mobility fosters a shift towards more self-directed health management. The goal is to illuminate how empowering individuals to navigate their health journeys can reshape the healthcare landscape, leading to earlier and more efficient interventions and potentially reducing the strain on emergency services.
With a goal to serve at least 4,300 individuals over the project’s timeline, envision a future where these individuals are active participants in their healthcare experience. Feonix’s research is not just about hitting numbers; it’s about meaningful engagement that could significantly reduce health issues by up to 31%. The intervention’s duration will be tailored, offering a unique glimpse into the varied experiences of participants, and building a comprehensive dataset that captures the real-world impact of improved transportation on health outcomes.
A Model for National Health Equity
The anticipated findings from Feonix’s study promise to do more than just provide data; they aim to inspire systemic change, presenting the Transportation Assistance Hub as a model for nationwide health equity. With the hope of demonstrating a potential reduction in health problems post-intervention, the project positions itself as a cornerstone for future health care and transportation policies, paving the way for a society where health equity is not just an ideal, but a reality.