Navigating public transportation: OT's role in SDoH

The Occupational Therapy Practice Framework: Domain and Process (OTPF-4; American Occupational Therapy Association [AOTA], 2020), emphasizes the significance of the impact of personal and environmental contexts on clients’ ability to engage in occupations. To gain a holistic understanding of our clients, we must consider the environment in which one was born and currently engages in occupations. This includes gaining an understanding of social determinants of health (SDoH). SDoHs include the environment in which we live, such as access to education, employment, food security, housing, transportation, socioeconomic status, and health care (Wilkinson & Marmot, 2016). Healthy People 2030 (U. S. Department of Health and Human Services, 2022) has recognized the impact of SDoH on overall health, well-being, and quality of life, all of which align well with the outcomes of occupational therapy identified in the OTPF-4. Occupational therapy students and practitioners need to understand how inequitable access to resources and support structures influences engagement contributing to overall health and well-being (Hammell, 2021). Further, the impact of physical, cognitive, and socioeconomic factors regarding access to healthy food, work, medical care, and leisure pursuits must be standardly assessed and addressed as part of the OT process (Synovec & Aceituno, 2019). Therefore, exploration into a client’s SDoH is an essential component for occupational therapy practitioners (OTPs) to consider when providing holistic services. Arguably, transportation is a large component of our clients’ environment that has an impact on access to services and resources in the community.