Geographic variations in driving time to US mental health care, digital access to technology, and household crowdedness

Sophia N D Negaro; Rachel M Hantman; Janice C Probst; Elizabeth L Crouch; Cassie L Odahowski; Christina M Andrews; Peiyin Hung

doi:10.1093/haschl/qxad070

Geographic variations in driving time to US mental health care, digital access to technology, and household crowdedness

Health Aff Sch. 2023 Dec 1;1(6):qxad070. doi: 10.1093/haschl/qxad070. eCollection 2023 Dec.

Authors

Sophia N D Negaro¹, Rachel M Hantman², Janice C Probst^{1

3}, Elizabeth L Crouch^{1

3}, Cassie L Odahowski^{1

3}, Christina M Andrews¹, Peiyin Hung^{1

3}

Affiliations

¹ Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, United States.
² Department of Psychology, University of South Carolina, Columbia, SC 29208, United States.
³ Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina,Columbia, SC 29210, United States.

Abstract

Rural residents face significant barriers in accessing mental health care, particularly as the demand for such services grows. Telemedicine has been proposed as an answer to rural gaps, but this service requires both access to appropriate technology and private space in the home to be useful. Our study documented longer travel time to mental health facilities in rural areas and greater barriers to digital devices for telemedicine access in those same areas. However, urban areas demonstrated greater household crowdedness than rural noncore areas when looking at private space within the home. Across ZIP Code Tabulation Areas located more than an estimated 30 minutes from the nearest outpatient care, 675 950 (13.1%) rural households vs 329 950 (6.4%) urban households had no broadband internet. The current Affordable Connectivity Program should target mental health-underserved communities, especially in rural America, where the scarcity of digital access compounds travel burdens to mental health care.

Keywords: access to care; digital access to telecommunication tools; geographic disparities; mental health; rural health; telemedicine; travel burden.