A recent study presented at the Infectious Disease Society for Obstetrics and Gynecology 2024 Annual Meeting has highlighted a concerning trend: transportation insecurity (TI) is significantly associated with lower rates of influenza vaccination among pregnant individuals. This research underscores the critical role of access barriers in healthcare outcomes, particularly during vulnerable periods such as pregnancy.
Background and Context:
Influenza vaccination during pregnancy is crucial for reducing healthcare costs and improving health outcomes for both mothers and infants. Despite clear clinical recommendations, the rate of influenza vaccination among pregnant individuals has declined from 61% in 2019 to 47% in 2022. This decline is accompanied by notable racial and ethnic disparities in vaccination rates.
Defining Transportation Insecurity:
Transportation insecurity is defined as the inability to access safe and reliable transportation to reach necessary destinations, including healthcare facilities where influenza vaccinations are administered. This barrier significantly impedes pregnant individuals from receiving timely vaccinations during prenatal care visits, which are pivotal for maternal and fetal health.
Study Methodology and Findings:
The study utilized data from the Behavioral Risk Factors Surveillance System survey conducted across 42 US states and territories in 2022. The survey included 1428 pregnant individuals who were stratified based on various demographic factors.
Key findings include:
Demographic Disparities: Younger pregnant patients (18-24 years), urban residents, and individuals from racial and ethnic minority groups (particularly Black patients) reported higher rates of transportation insecurity.
Insurance and Income Impact: Uninsured individuals and those with lower household incomes (< $25,000 annually) were significantly more likely to experience transportation insecurity.
Vaccination Disparities: Pregnant individuals with transportation insecurity had significantly lower rates of influenza vaccination (16.3%) compared to transportation-secure individuals (40.7%). This disparity persisted even after adjusting for income, race, and type of health insurance.
Implications and Recommendations:
The study underscores the urgent need for interventions to mitigate transportation barriers for pregnant individuals. Recommendations include:
Policy Interventions: Implementing policies that improve transportation access for vulnerable populations, especially in urban areas and among racial minorities.
Healthcare Strategies: Integrating influenza vaccination services into broader prenatal care initiatives to ensure accessibility and uptake among pregnant patients.
Community Outreach: Engaging community organizations and healthcare providers in outreach efforts to educate and facilitate vaccination for pregnant individuals facing transportation challenges.
Conclusion:
Addressing transportation insecurity is essential for improving maternal and fetal health outcomes by ensuring equitable access to preventive healthcare services like influenza vaccination during pregnancy. Future research and policy efforts should focus on reducing access barriers to promote health equity among all pregnant individuals.
In summary, the study underscores the critical need to address transportation insecurity as a determinant of healthcare access and vaccination uptake among pregnant individuals, aiming to improve maternal and infant health outcomes nationwide.
