Racial disparities in travel time to radiotherapy facilities in the Atlanta metropolitan area

Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, 4770 Buford Hwy, NE, K-55, Atlanta, GA 30341, USA. Electronic address: .
Social Science [?] Medicine (Impact Factor: 2.89). 07/2013; 89C:32-38. DOI: 10.1016/j.socscimed.2013.04.018
Source: PubMed


Low-income women with breast cancer who rely on public transportation may have difficulty in completing recommended radiation therapy due to inadequate access to radiation facilities. Using a geographic information system (GIS) and network analysis we quantified spatial accessibility to radiation treatment facilities in the Atlanta, Georgia metropolitan area. We built a transportation network model that included all bus and rail routes and stops, system transfers and walk and wait times experienced by public transportation system travelers. We also built a private transportation network to model travel times by automobile. We calculated travel times to radiation therapy facilities via public and private transportation from a population-weighted center of each census tract located within the study area. We broadly grouped the tracts by low, medium and high household access to a private vehicle and by race. Facility service areas were created using the network model to map the extent of areal coverage at specified travel times (30, 45 and 60 min) for both public and private modes of transportation. The median public transportation travel time to the nearest radiotherapy facility was 56 min vs. approximately 8 min by private vehicle. We found that majority black census tracts had longer public transportation travel times than white tracts across all categories of vehicle access and that 39% of women in the study area had longer than 1 h of public transportation travel time to the nearest facility. In addition, service area analyses identified locations where the travel time barriers are the greatest. Spatial inaccessibility, especially for women who must use public transportation, is one of the barriers they face in receiving optimal treatment.

19 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Interest in the application of systems science (SS) in biomedical research, particularly regarding obesity and noncommunicable chronic disease (NCD) research, has been growing rapidly over the past decade. SS is a broad term referring to a family of research approaches that include modeling. As an emerging approach being adopted in public health, SS focuses on the complex dynamic interaction between agents (e.g., people) and subsystems defined at different levels. SS provides a conceptual framework for interdisciplinary and transdisciplinary approaches that address complex problems. SS has unique advantages for studying obesity and NCD problems in comparison to the traditional analytic approaches. The application of SS in biomedical research dates back to the 1960s with the development of computing capacity and simulation software. In recent decades, SS has been applied to addressing the growing global obesity epidemic. There is growing appreciation and support for using SS in the public health field, with many promising opportunities. There are also many challenges and uncertainties, including methodologic, funding, and institutional barriers. Integrated efforts by stakeholders that address these challenges are critical for the successful application of SS in the future. © 2015 American Society for Nutrition.
    Advances in Nutrition 01/2015; 6(1):88-95. DOI:10.3945/an.114.007203 · 4.71 Impact Factor