The cost of health related travel from a remote community

Objective: To quantify the amount of health care related travel undertaken by residents of a remote Island community in Australia and the associated carbon emissions, and determine the impact and rationale for residents in travel decisions.

Method: A population travel survey of all households on King Island, situated off the North West of Tasmania. All households were visited by interviews teams over a one week period and health related travel events recorded for the year 1 July 2011 and 30 June 2012. Claims for travel reimbursement were also identified from the DHHS database.

Results: 511 travel events were experienced by 625 respondents (40% of population), travelling 346,573 km and generating 0.22 tCO2e per capita. Emissions associated with air travel are comparable with large petrol and diesel vehicles used widely throughout rural Australia. Substantial travel was incurred at residents own expense, with the decision to access health care in Victoria rather than Tasmania. These decisions were based primarily on reducing the time ‘off island’ to minimise loss of income and impact on family, the location of social networks and support often being based in Victoria, to minimise the ‘camel ride’ of navigating multiple modes of transport to reach the care destination, to expedite care and to secure better care co-ordination as well as care continuity.

Conclusions: Remote residents pay a significant additional cost burden to access health care, associated with the need to travel to appointments. The cost of this travel is likely to increase with dependence on fossils fuels for transports. This travel generates significant carbon emissions and environmental impacts. In addition it is important to recognise the cost to remote residents extends beyond financial, impacting work, school, family, psychological and emotional wellbeing.