THE IMPACTS OF FREE TRANSPORTATION ON HEALTH: A SCOPING REVIEW OF GLOBAL LITERATURE AND A SASKATCHEWAN CASE STUDY ON OLDER ADULTS
Bibliographic record
Abstract
Introduction: Transportation is one of the major social determinants of health, especially for older adults residing in rural and remote areas with limited mobility options. The closure of the Saskatchewan Transport Company in May 2017 in Saskatchewan created significant gaps in intercity transit as it connected smaller communities to resources, including delivery of goods and medications. This research reviewed the global literature on free transportation and health outcomes. It also explored the impact of a community-based free transportation initiative operated by the Kikinahk Friendship Center in La Ronge, Saskatchewan, on the well-being of older adults. Methodology: This thesis involved two interrelated studies- a scoping review and a qualitative case study. For the scoping review, four databases were searched, resulting in 8,745 articles which 28 studies met all the criteria. The qualitative case study involved 9 semi-structured interviews with older adults (65 years and older) and 6 conversation circles involving 18 community stakeholders, bus drivers, elders, and service users. Qualitative data analysis was conducted through thematic analysis using Braun and Clarke’s six-phase framework. Findings: The scoping review revealed that there are different types of free transportation programs globally, including concessionary bus passes, bus passes for people with disability, rail transit passes, and passes connected to rideshare initiatives. Free transportation initiatives improve health and socioeconomic outcomes through enhancing accessibility to healthcare services, improving physical activity, obesity, depression, cardiovascular diseases, improved social inclusion, better access to essential services and better access to educational opportunities. The Saskatchewan case study revealed that free transportation influences the well-being of older adults in different ways and that the initiative faced major barriers. First, free transportation was seen as an important tool that influences health and daily living, by enabling access to healthcare, shopping, and cultural participation for older adults living in northern Saskatchewan. Second, older adults who made use of the free bus service reported emotional benefits including enhanced autonomy, reduced stress, and improved sense of dignity. Finally, barriers to the free bus service were identified, including lack of age-friendly bus stops, communication barriers, and inconsistency in financing the free bus service. Conclusion: Free transportation in many parts of the world is associated with improved health. Free transportation not only enhances access to health care for older adults but also supports their emotional and socioeconomic well-being. Having sustainable policy and stable funding mechanisms, improved communication, and age-friendly design are all essential to improving the effectiveness of free bus services. This research study adds to the growing literature advocating for transportation equity as an important tool in public health and policy planning for older populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.029 | 0.050 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".