Public transport availability and healthcare use for Australian adults aged 18–60 years, with and without disabilities

Introduction: Public transport (PT) availability may be more important for people with disabilities (PWD), as typically they have greater healthcare needs and mobility barriers compared with people without disabilities. This paper investigates how PT availability is associated with healthcare use for people aged 18–60 years, with and without disabilities in Australia. Method: We used unique Australian healthcare use administrative data linked to the 2016 Census, where individuals report whether they have a disability (severe or profound core activity limitation). These data were merged with detailed information on local area PT availability for Australia's 21 largest cities. We estimated regression models to examine the association between PT availability and different types of healthcare use, while controlling for individual characteristics and larger area attributes. Results: PT availability was positively associated with visits to general practitioners (GP), with a higher magnitude observed for people with disabilities (PWD). While people without disabilities had on average 0.1 more GP visits per year when PT availability was high compared with low, PWD on average visited their GP 0.5 more times per year if they lived in areas with high as opposed to low PT availability. Nervous system prescriptions (which includes antidepressants) were 0.27 per year fewer for PWD living in areas with high compared with low PT availability. Conversely, nervous system scripts were 0.06 higher for people without disability with high compared with low PT availability. Conclusion: We conclude that PT availability is likely to be a key factor of healthcare use. Increasing PT availability may help overcome some barriers to healthcare use for PWD. Our findings are also consistent with PT increasing access to preventive care, which may reduce the severity or better management of illnesses. PT can play an important role in improving health and decreasing health inequalities between those with and without disabilities.