P3828 - Impact of Neighborhood-Level Transportation Insecurity on Colorectal Cancer Screening in the United States

Award: Presidential Poster Award

Misha Gautam, MD¹, Utkarsh Goel, MD², Vinay Jahagirdar, MD¹, Evans Aron, MD¹, Tahar M. Mahmoudi, MD¹, Esmat Sadeddin, MD¹, Hassan Ghoz, MD^1
1University of Missouri - Kansas City School of Medicine, Kansas City, MO; ²Cleveland Clinic Foundation, Cleveland, OH

Introduction: One in four adults in the US experienced some form of transportation insecurity in 2018. Inadequate access to reliable transportation is an underappreciated social determinant of health (SDOH) and can have implications on individual and population level health outcomes

Methods: We linked the Centers for Disease Control and prevention (CDC)’s PLACES database with the Agency for Healthcare Research and Quality’s SDOH Health database. We then assessed the proportion of households not having access to a vehicle, proportion of workers using public transit to commute to work, and proportion of workers having to walk to commute to work (not using personal, public, or other forms of transport) on Census tract-level age adjusted prevalence of colorectal cancer screening among adults 50-75 years of age in the year 2020 using multiple linear regression (LR)

Results: Of the 72,305 neighborhoods included in PLACES, 49,358 neighborhoods with complete variables of interest comprised our study cohort. Prevalence of up-to-date colorectal cancer screening was highly variable across neighborhoods (median 70.6%, range 34-88%). After accounting for median household income and neighborhood population, the proportion of households without access to a vehicle was significantly associated with decreased colorectal cancer screening (LR coefficient for 10^th decile vs 1^st decile = -0.65, p< 0.001). Areas with the greatest distance to the nearest health clinic experienced a greater detrimental effect of vehicle unavailability on colorectal cancer screening (LR coefficient for 10^th vs 1^st decile= -3.39, p< 0.001, Figure 1). Similar trends were seen with proportion of workers having to walk to commute to work.

Discussion: Higher transportation insecurity in US neighborhoods was significantly associated with lower rates of colorectal cancer screening, especially in areas lacking local proximity to their nearest health clinics. These findings encourage policy efforts to increase physical proximity to healthcare access in US neighborhoods and highlight the possible role of screening for transportation insecurity during primary care delivery to improve the rates of age-appropriate cancer screening.



Disclosures:


Misha Gautam, MD¹, Utkarsh Goel, MD², Vinay Jahagirdar, MD¹, Evans Aron, MD¹, Tahar M. Mahmoudi, MD¹, Esmat Sadeddin, MD¹, Hassan Ghoz, MD¹. P3828 - Impact of Neighborhood-Level Transportation Insecurity on Colorectal Cancer Screening in the United States, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.