Roads to Wellness: A System Analysis of Crucial Links between Transportation and Health in West Virginia
Roads to Wellness project brought together experts and multi-sector stakeholders from across West Virginia in three virtual roundtable discussions. The goal was to produce a project report synthesizing the system analysis, logic models, and strategic plan with prioritized policy actions to enhance West Virginians’ health by addressing transportation challenges.
Project leadership included Dr. Joan Centrella, former Director of the Bridge Initiative in Science and Technology Policy, Leadership, and Communications; Dr. Deb Koester, Assistant Professor and Director of the Division of Community Health at Marshall University; and Dr. Deborah D. Stine, Study Director and Consultant to WVU, and Founder of the Science & Technology Policy Academy. An advisory committee of health and transportation experts provided guidance on study activities and content.
Study Question
What actions, if any, should West Virginia policymakers (national, state, local, for-profit, and non-profit organizations) take to respond to concerns that insufficient transportation options are reducing the quality and quantity of healthcare received by West Virginians with chronic disease? (e.g., congestive heart failure, diabetes, COPD, depression & anxiety)
Project Activities
The project activities include roundtables to gather input from stakeholders, followed by “town hall” events at transportation and healthcare annual meetings and other events in West Virginia to receive feedback on the draft report based on the roundtable discussions in the summer and fall of 2024. The report is expected to be completed by December 2024, with dissemination activities occurring throughout 2025.
During the roundtables, participants will brainstorm policy options to respond to the roundtable topics below, then discuss the pros and cons of each identified policy option based on the following 4E criteria:
- Effectiveness: The degree to which a societal goal is likely to be reached.
- Efficiency: The cost of implementing the policy relative to its effectiveness.
- Equity: The fairness of the policy. Who are the winners and losers?
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Ease of political acceptability: The degree to which the policy is opposed
or supported by key stakeholders.
Roundtable participants will individually prioritize options based on that 4E analysis in an anonymous poll. Science & Technology Notes will have background information and some potential policy options based on actions in other Appalachian states. The three invitation-only stakeholder roundtables on the following topics will take place in April 2024 are:
Roundtable 1: Health on the Move: Bridging Transportation and Care through Telemedicine, Mobile Clinics, and Integrated Models in West Virginia
"Health on the Move" Roundtable participants will explore the critical role of transportation in healthcare delivery to West Virginians with chronic disease (e.g., congestive heart failure, diabetes, COPD, depression & anxiety). Topics participants will discuss include policy options that provide the opportunity for enhancing the use of (1) telemedicine to offer a viable alternative for patients in remote areas of West Virginia, eliminating the need for physical travel; (2) mobile clinics to serve West Virginia communities with limited transportation options, so that essential healthcare services are brought directly to those in need; (3) integrated care models partnering with transportation organizations to facilitate diverse and flexible patient care settings (e.g., Uber, Lyft); and (4) actions to respond to insufficient local healthcare workers to provide primary and specialty care. By exploring these critical elements, the roundtable will highlight innovative strategies and policy initiatives aimed at leveraging transportation to enhance healthcare access and delivery to bridge transportation and care.
Roundtable 2: Country Roads to Prevention: Integrating Transportation for Enhanced Population and Community Health in West Virginia
“Country Road to Prevention” Roundtable participants will delve into how transportation options for West Virginians, or the lack of them, directly impact population and community health, particularly through the lens of health promotion and disease prevention strategies. This discussion will cover the pivotal role of transportation in facilitating primary prevention efforts, such as enabling consistent access to health check-ups, screening tests, and vaccinations for West Virginians. It will also explore the critical importance of secondary prevention, where consistent and cost-effective transportation options can be lifesaving by ensuring that individuals with existing health conditions receive timely care and management, thus averting complications or worsening of their conditions. By examining these aspects, the roundtable aims to shed light on policy options and practical measures that can strengthen the link between transportation and healthcare, ultimately supporting community-wide health and wellness for all West Virginians.
Roundtable 3: Bridging the Health Divide: The Intersection of Transportation and Health Equity in West Virginia
“Bridging the Health Divide” Roundtable participants will explore how West Virginian's access to transportation serves as a fundamental social determinant of health, impacting health equity across various communities. The U.S. Department of Health and Human Services defines social determinants of health as “the conditions and environments in which people are born, live, learn, work, play, worship, and age.” This roundtable will examine the challenges of accessibility in rural areas of West Virginia, where the scarcity of transportation options can severely limit access to essential healthcare services, nutritious food, and physical activity opportunities, further entrenching health disparities. Discussions will also focus on the critical role of reliable transportation in economic stability, emphasizing its importance in securing employment and, by extension, healthcare access for West Virginians. The roundtable will also address the intersections of education, including literacy and digital literacy, with the ability to navigate transportation and healthcare systems. By examining these aspects, the roundtable aims to shed light on policy options and practical measures to address social determinants through transportation solutions to overcome these barriers and move towards greater health equity for all West Virginians.