Measuring Income and Racial Inequality in Transportation Access to Emergency Medical Services: Method Development

Abstract

Transportation access to emergency healthcare is an important element to intraurban equity that is currently under researched, measured, and addressed. This study develops a methodology to generate trips of multiple modes (driving, walking, and transit) from homes to emergency hospitals at different times to compare trip dimensions at the census block group level and the independent variables behind them. It also explores the effects of income, race, and the joint impacts of income and race geospatially. Income and race disparity ratios and two-sample one-tailed t-tests are used to consider the transportation inequalities (through time, distance, and cost dimensions) by different non-white population representation and income levels. Linear regressions with multiple covariates explore each racial minority group’s impact on transportation dimensions for Black, Asian, and Native American residents. Finally, the impacts of redlining on transportation dimensions are investigated by using a one-sample t-test as well as geospatial analysis. The application of the proposed methodology on St. Paul, Minnesota reveals that lower income block groups were found to have greater trip times and cost burdens than higher income block groups at both 12am and 4pm. Cost burden for Asian people were found to be more elastic to transit cost changes from 12am to 4pm. Monday 12am and 4pm trip departures were chosen because they were hypothesized to represent one of the worst and best times to access public transportation. Historically designated “Definitely declining” or “C” groups were found to have the highest travel times and cost burdens while historically redlined “Undesirable” or “D” groups had the lowest travel times and lower cost burdens compared to other groups.