In the final session of the workshop, Vince Valdes, the associate administrator for research, demonstration, and innovation at the Federal Transit Administration (FTA) in the U.S. Department of Transportation, reflected on the workshop on behalf of the sponsor organization. There has always been a connection between transportation and health care, he said. This workshop at the National Academies of Sciences, Engineering, and Medicine (the National Academies) has helped to bring it to the forefront. This conversation needs to continue, he said, and he shared his perspective on next steps for moving forward. In particular, he suggested several actions that will be important to success:
- Establish a shared value system focused on making people’s lives better. In establishing those basic shared values, Valdes said, it will be important to remember that this is an endeavor for people. It is person-centric, traveler-centric, and patient-centric. In providing better health care and providing better transportation to health care, people are providing the aspects that make for a better quality of life.
- Develop a common language. Valdes observed that even at the workshop there were differences among the panelists in terms of the language they use and the stakeholders they serve.
- Define common metrics. It is important to start measuring those factors in people’s lives that make for better living overall, Valdes said, including the quality of life and the quality of health care. It
will also be important to agree on common metrics and measures of success and to be able to demonstrate that the people who are being served are getting better service, are satisfied with the service, and are experiencing a better quality of life.
- Continue to pilot new models of providing transportation services to enhance life. From the FTA perspective, Valdes said, it is important to continue to pilot new and exciting ways of providing transportation services for different sectors and client bases and to pilot these opportunities through partnerships. Rides to Wellness is based on the mobility-on-demand model, which has broader goals than just wellness, Valdes said. It is really “rides to life,” he said, and he suggested that a ride should be a ride, whether to recreation, to health care, or to a job. People need transportation; it is at once a commodity, a utility, and a social service, he said. Through the Mobility on Demand demonstration program, FTA is looking for best practices and innovative pilots of user-centric approaches to providing different aspects of service for people who need it.
- Reach out across federal agencies to get perspectives on the user base for public transportation. It will be important going forward, Valdes said, to continue relationships across sectors and to reach out across the federal space to help bring the perspectives of the diverse user base to public transportation.
Ysela Llort called on participants to share their final observations. Many took the opportunity to highlight available resources and opportunities. Participants also offered additional thoughts on next steps.
A webcast participant agreed with the need for uniform definitions and emphasized the importance of focusing on data that can make the case to funding agencies. Information such as lost revenues due to lack of transportation is useful. Webcast viewer Suzanne O’Neill commented that measuring how transportation is able to keep people living independently is important because it relates to quality of life. Better efforts are also needed to match costs and benefits, she added. It will not possible to increase resources for transportation if the local communities are being asked to pay for the costs, while the benefits are occurring at the state or federal levels or going to a for-profit dialysis center, for example. The participant stressed that those at the federal level need to have the ability to make the best decisions for resources and mobility. The current system, in which the program is left trying to shift costs to others, is not sustainable.
Webcast participant Charlotte Frye asked why it appears to fall to FTA to meet mobility needs, while the Federal Highway Administration (FHWA) focuses on moving vehicles. In other words, why is the connection to health care directed to FTA, when it should be a larger objective for all of the U.S. Department of Transportation (DOT)? Valdes responded that FHWA is as committed to mobility as FTA and other stakeholders. As an example of its activities, he said that FHWA is currently funding the Accessible Transportation Technology Research Initiative, an initiative to facilitate mobility for people with disabilities. U.S. DOT is unified in its commitment to a multimodal approach to transportation.
Resources and Opportunities
Valerie Lefler told participants that $377 million in research funding will be awarded through the University Transportation Center program grant competition out of the Office of the Assistant Secretary for Research and Technology. The focus of the funded research over the next 5 years will be ways to improve the mobility of people and goods. She encouraged participants to watch the website for the forthcoming announcement of the national, regional, and tier 1 University Transportation Centers.1 The research dollars are there, she said, and the office will be looking for topics to study. Valdes added that the Transit Cooperative Research Program and the Highway Cooperative Research Program, both administered by the Transportation Research Board (TRB), are soliciting ideas for research.2
Karen White informed participants that FTA has three technical assistance centers available to help them. The National Rural Transit Assistance Program collects, disseminates, and aids best practices for rural transportation. The National Aging and Disability Transportation Center assists Section 5310 program recipients in providing services for older adults and people with disabilities. The National Center for Mobility Management aids and provides technical assistance with regard to mobility management for all sectors of the transportation industry.3
Llort reminded participants that some of the surveys discussed at the workshop are seeking input on revisions and encouraged them to take the opportunity to comment (specifically, the 2018 redesign of the National Health Interview Survey discussed by Marcie Cynamon).4
Ed Christopher encouraged participants to sign up for the listserv of the TRB Health and Transportation Subcommittee, which is focusing
2 See http://www.trb.org/AboutTRB/AboutCooperativeResearchPrograms.aspx (accessed August 4, 2016).
on health and transportation issues broadly (i.e., not limited to access to care).5 He also alerted participants to the TRB 2016 John and Jane Public Competition, which is seeking best practices in communicating the connection between transportation and public health to the average citizen on the street.6
Final Thoughts to Inform Future Work
Oscar Gomez highlighted the need for more awareness, observing that much has been done, and is currently being done, but many working on the health care side are not aware of these activities. He offered to try to document the current partnerships and identify key stakeholders on the transportation side and the health care side as well as some potential partners from other sectors (e.g., foundations).
Martin Ornelas suggested that a formal assessment of all the current federal agencies involved in transit would also be highly valuable. Kate Lawson suggested the need for a clearinghouse of information about developing partnerships, such as navigating nondisclosure agreements, accessing data within the parameters of the Health Insurance Portability and Accountability Act, and working with institutional review boards.
Jana Lynott said that many good research ideas were presented at the workshop and suggested that a research proposal be developed that spans both the transportation sector and the health sector for submission to the TRB Transit Cooperative Research Program and the Health and Medicine Division of the National Academies. Llort suggested that proposals for both short-term and longer-term type of activities would be of interest.
Steve Yaffe suggested convening a planning committee that can refine the objectives for developing a common dataset. The next step would be to invite experts in the data discussed at the workshop to conduct a mapping project to draw the links of commonality across sectors and consider how and whether it will be possible to come together on the common objectives.
This has to be a continuing dialogue if the community is indeed committed to making a change and to improving that which it values, which is human life and wellness, Llort concluded.
6 For more information, see https://sites.google.com/site/trbcommitteeada60/jjpcompetition/ 2016-communicating-the-connection-transportation-and-public-health (accessed August 4, 2016).