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- 13 - accessHealthNews.net Fall Special Edition 2021 Volume 8 | Issue No. 49 T he Missouri Rural Health Association (MRHA) Get Link'd 2021 Conference featured several breakout sessions breaking down the role transportation plays within social determinants of health. Speakers highlighted the impacts inadequate transportation has on rural, suburban, and urban communities alike and what equitable transportation may look like. During "Mobility Management: A Collaborative Solution for a Complex Issue," Sherry McDonald, Ed. D. and Administrative Consultant II, MU Extension and School of Medicine's Office of Health, Outreach, Policy, and Education (HOPE) detailed her collaborative efforts expanding transportation access across Missouri. McDonald, along with MU Extension and MRHA, spent 2020 developing curriculum for a Mobility Management Certification Program. Mobility management does not have a singular definition, but possesses four key pillars: coordination, collaboration, advocacy for the unheard, and liberated access to transportation. MOBILITY MANAGEMENT McDonald recalled first hearing the phrase "mobility management" on April 22 of last year. Though she was unsure of exactly what equitable access to transportation in Missouri should look like, her team filled in the rest. "I had one piece of this, and the rest of the huge team had the rest of the pieces," she said. "We could not have done this alone. I cannot stress how collaborative this was and how necessary it was to build these programs." According to McDonald, the team presented a problem statement identifying how inadequate transportation can be a barrier to a fulfilling life and the impact it has on a person's physical and mental health. They knew where they wanted to end up, but had yet to articulate how they would get there. Mary Gordon, MRHA's HealthTran Director, filled in the gaps. She envisioned a collaborative transportation network of available rides and vehicles in the community – not just for medical care needs, but also pharmacy and grocery trips and social outings. "That is equitable transportation," McDonald said. "We aren't just looking for equitable, we want liberation without bias." During the Q&A portion, an audience member posed a question about equity in transportation. She provided the example of clients without driver's licenses due to probation or trouble with the law. They may have to attend meetings with parole officers and court dates, but have no license to drive. Being late or missing a meeting can result in being sent back to jail, making public transportation an impractical solution. These people also need their employer to allow them to leave work during the day, as well as rely on transportation to and from work to these meetings and appointments. The audience member asked, "How do these people fit into mobility management?" Gordon responded, "What you're talking about is what a mobility manager needs to know in their community. There may be resources there that people don't know about." According to Gordon, many pockets of funds exist but are unused, simply because people are unaware. LIBERATING TRANSPORTATION In rural areas, lower population density results in a lack of investment into infrastructure, making what little transportation is available inconvenient, unaffordable, or unreliable. Transportation barriers have long plagued Missouri communities. While the state has the seventh-largest infrastructure system in the U.S. – bigger than that of Kansas and Illinois combined – Missouri ranks 45th nationally in revenue per mile. Hospitals, pharmacies, and grocery stores may be out of reach without a vehicle, directly impacting the health and wellbeing of rural residents. "As mobility managers, the largest problem we see is nobody talking to all the silos and connecting the dots, having conversations, and listening." - Mary Gordon, MRHA HealthTran Director

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