Lack of adequate transportation is often cited as a reason for not seeking or receiving health care by people who cannot or do not drive. Aware of the critical role that inadequate transportation access to health facilities plays in the health of Bay Area residents, the Transportation and Land Use Coalition (TALC) initiated a study to investigate this problem. The resulting report, Roadblocks to Health, which was released in 2002 in conjunction with two social justice groups, looked at transit and walking access to health care in 15 low-income communities in the region. That study found that residents of Contra Costa's low-income neighborhoods had the worst access to health care of the three counties studied. These communities have many residents that do not drive; at the same time, infrequent transit service and spread out land use make clinics and hospitals difficult to reach.
The California Endowment then funded TALC to initiate the Transportation Equity and Community Health (TEACH) project to bring together community members and transportation and health agency staff to address these problems. In Concord's Monument Corridor and Pittsburg/Bay Point, specific obstacles to health care facilities by transit and walking were identified through needs assessments with community members and health officials. These obstacles were then prioritized through community forums held in October 2004. Implementing these solutions, which include improvements such as more benches and shelters at bus stops, bilingual information, volunteer shuttles, and more frequent bus service, has been the mandate of the TEACH Working Groups consisting of community, health and transit representatives.
Since 2004, the Working Groups have had remarkable successes, especially on issues that could be addressed through cooperation and communication. In the Monument Corridor, for example, the Working Group's activities have led County Connection to start a new bus route to health facilities in downtown Concord and to improve informational materials for monolingual Spanish speakers; the City of Concord has also committed to installing more benches at bus stops. In Bay Point, Tri Delta Transit is starting to improve informational materials for Spanish-speakers, has installed bus shelters in the neighborhood, and has developed a new three-year marketing plan that addresses a number of issues identified by Working Group members.
However, some items that could greatly improve access to healthcare in these communities cannot happen without new funding sources. To provide more direct and frequent transit to healthcare for Monument Corridor residents, for example, a new route that links health care facilities or a community shuttle is needed. Similarly, Bay Point's need for more frequent service and additional bus shelters require additional funding.
In 2006, both TEACH project neighborhoods, Concord's Monument Corridor and Pittsburg/Bay Point, will conduct Community Based Transportation Plans (CBTP). These planning processes, sponsored by the Metropolitan Transportation Commission (MTC), emphasize community involvement in prioritizing transportation needs and identifying potential solutions in low-income neighborhoods. As the two neighborhoods prepare to develop first-ever CBTPs, this paper examines the progress to date and roadblocks not yet overcome in the TEACH project in Contra Costa County.
Community-Based Transportation Plans give the TEACH Working Group members, who have been focused on access to health, a chance to broaden their scope and help identify other access issues. What's more, money will be available to fund these projects, making resident's demands for better access to health care in the CBTP process particularly timely! In spring 2006 Contra Costa County will have over $2 million available for Lifeline Transportation needs, some of which can be used to fund transportation solutions already identified by the TEACH project.
This report provides an outline of the TEACH project priority solutions, progress to date, and remaining needs. Also included are maps, Access to Health Care for Monument Corridor and Access to Health Care for Pittsburg and Bay Point, which show key locations, routes, and frequencies. Below are some of the priorities described in the report:
|More bus shelters and benches||Monument Corridor||Community Development Block Grant will fund 35 benches in locations identified by the Working Group bus stop survey.|
|Improve bilingual transit information materials and availability||Monument Corridor||County Connection secured funds for extensive bilingual outreach and materials, plus a travel-buddy program for Latino residents. CC's customer phone line now serves Spanish speakers, and new discount pass sales locations in the Monument distribute bilingual information.|
|Increase frequency of buses connecting to health clinics||Monument Corridor||County Connection has restructured line #115 and created a neighborhood loop #115B. The change doubled the frequency to the Concord Health Center and to the John Muir Medical Center.|
|*Bus service to food pantry||Monument Corridor||County Connection's route #111 now serves St. Vincent de Paul, helping residents to take home goods from the pantry.|
|More bus shelters and benches||Bay Point/Pittsburg||Two shelters have been installed at locations identified by residents at the January 2005 TEACH community forum; a third is expected in July 2006.|
|Increase frequency and decrease transfer wait time of buses to clinics||Bay Point/Pittsburg||Tri Delta Transit created a new stop on rte. #200 at the BART station, cutting 45 minutes from the trip to CCRMC and adding another quick connection from BART to the Pittsburg Health Center and La Clinica.|
|*Improved bilingual transit information||Bay Point/Pittsburg||Tri Delta Transit has implemented the Working Group's suggestions for improvements to marketing materials and developed a new three-year marketing plan proposing extensive outreach to the Latino community.|
|Increased coordination between health and transit agencies||Countywide||Representatives from the Contra Costa Health Access Coalition regularly attend Transportation Alliance meetings and vice versa. The Health Access Coalition hosted two transportation-focused meetings.|
* Indicates a priority that emerged from the TEACH Working Group meetings.