Transportation Issues in Rural Healthcare

Article information

J Prev Med Public Health. 2020;53(2):149-150

Publication date (electronic) : 2020 March 31

doi : https://doi.org/10.3961/jpmph.20.038

Kazuhiko Kotani

Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan

Corresponding author: Kazuhiko Kotani, MD, PhD Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Japan E-mail: kazukotani@jichi.ac.jp

Dear Editor,

We read with great interest the recently published paper by Choi et al. [1], which highlighted the inconvenience of transportation as a major barrier to the accessibility of healthcare for older people living in rural areas. Of note, the authors mentioned the need to consider public transportation to healthcare institutions in the Discussion section [1]. The authors also pointed out that the use of public transportation has received little attention in Korea relative to other countries, such as the United Kingdom [1]. This issue is very important for maintaining and improving the health and welfare of residents of rural communities worldwide [2]. We would like to add some comments on the current situation in Japan to contribute to further discussion of this topic.

The inclusion of public transportation in rural healthcare policies has not been thoroughly examined in Japan, similarly to the situation in Korea. In rural communities, buses are the means of public transportation most familiar to residents. A prime example is the community bus, which drops off riders at various clinics within the community and makes stops at hospitals (Figure 1). On-demand taxis and/or rideshare taxis are other means of transportation, although their use is often studied from a private rather than public perspective, and in urban areas rather than rural areas [3]. Rural governments should consider investing more resources into improving transportation services and systems. Simultaneously, at the level of the national government, collaborative action between the Ministry of Health, Labour and Welfare (which has jurisdiction over rural healthcare) and the Ministry of Land, Infrastructure and Transport (which has jurisdiction over transportation) is needed.

Figure. 1.

An image of a community bus.

Rural communities are rapidly aging, and aging-related declines in the physical and/or cognitive function of older rural residents have made it difficult for them to visit healthcare institutions and/or retain their driver’s licenses [4,5]. This matter therefore needs to be discussed urgently.