Social Determinants of Health (SDOH)

Social Determinants of Health (SDOH): Where Does Transportation Fit?

MTM is synonymous with non-emergency medical transportation (NEMT), an incredibly important component of ensuring Medicaid and Medicare members can access healthcare—but what if there was something more health plans could do to provide community transportation for their members, with the ultimate goal of improving health outcomes, reducing healthcare expenses, and encouraging members to improve their quality of life?

NEMT services are traditionally leveraged to minimize the gap between members and access to healthcare. However, these members also face challenges in accessing other aspects of their communities, primarily services revolving around social determinants of health. Using NEMT to ensure members get to their medical appointments is only half the battle in improving health outcomes and ensuring long-term social wellbeing. Led by Director, Social Determinants of Health and Product Development Tamara Carlton, MTM is leading the way in helping our clients mitigate the impact of SDoH.

MTM helps our clients reduce the impact of Social Determinants of Health (SDOH) like access to quality healthcare, economic stability, neighborhood and physical environment, education, food quality and stability, and community and social contact.

The Important Role of Social Determinants of Health

Forward thinking managed care organizations realize that social determinants of health play a huge role in health risks and outcomes. In fact, according to the Robert Johnson Wood Foundation, these factors can drive as much as 80% of health outcomes.

A healthy lifestyle starts in our homes, schools, workplaces, neighborhoods, and communities, and unfortunately, is frequently predetermined by the social and economic opportunities afforded to us. Medicaid members, who are low-income by definition, are especially at a disadvantage, as they often struggle with basic needs like food, employment, and shelter—which negatively impacts their future health.


Where Does Transportation Fit?

Transportation is a missing piece of the puzzle. When a member has access to reliable transportation, they have a way to get to better employment and education opportunities; an improved ability to connect with friends and family for social and recreational outings; and a consistent method for accessing basic daily needs like grocery stores, pharmacies, and healthy food options.

Every year, MTM provides more than 20 million trips to members connecting with healthcare services. We’re ready to help you do more with our robust existing networks and customer service facilities, and can support you in expanding your transportation benefit to include more than just trips to the doctor.

We are the transportation partner that can help you bridge the gap between members and community:

Economic Stability & Employment

Economic Stability & Employment

Employment impacts so much of our daily lives: our overall economic stability, our ability to afford food and housing, and our overall feeling of self-worth. According to the Brookings Institution’s Metropolitan Policy Program, nearly 40 million working age US citizens live in metropolitan areas that lack public transportation, lessening their ability to get to places of employment. These struggles are even more difficult for people who are low-income and can’t afford a personal vehicle, as well as individuals with disabilities. In the long-term, limited access to employment can result in long-term economic hardship, generational wage gaps, social isolation, inability to sustain a healthy lifestyle, and a lower perception of meaning and self-worth.

How can MTM help you address access to employment among your membership?

  • We can work with you to provide transportation to job training, career fairs, and other community resources that assist in job placement
  • Through our community outreach teams, we can raise awareness for existing public transit options and other transportation resources
  • We can establish recurring trips for members to help them get to and from their worksites
Neighborhood & Physical Environment

Neighborhood & Physical Environment

Based on research from the Monroe Group, 46 million U.S. residents live in poverty, which negatively impacts their ability to afford quality housing. Housing quality is so much more than just the neighborhood we live in—it also refers to the physical environment of our homes, from air quality and presence of toxins like mold and asbestos, to the space allotted per resident. Low-income families, like those who qualify for Medicaid, are more likely to live in poor quality housing that can have long-term negative effects on health, including chronic disease, injury, and poor mental health.

How can MTM help you address physical environment and housing quality among your membership?

  • We can provide transportation to parks, events, and other recreational activities to reduce the amount of time members spend in potentially hazardous home conditions
  • Partnering with community programs and housing associations, we can transport materials and equipment for home modifications to help housing pass safety inspections
  • Working with local city and county governments, we can create programs that provide transportation to work, school, grocery stores, and other destinations that promote upward mobility to those who reside in government housing


From traditional schooling to job training, literacy, and vocational skills, access to education has a direct impact on other social determinants of health like employment and living conditions. According to 2016 research from The Nation’s Health, individuals over the age of 25 who lack a high school degree have an 8% unemployment rate, compared to a 2.8% unemployment rate among those with a college degree. The same study also found that those who graduate from college live an astounding five years longer on average than those who don’t finish high school.

A lack of education has a direct correlation with lack of employment, which can lead to long-term economic hardship, wage gaps, and social isolation.

How can MTM help you address access to education among your membership?

  • For low-income families without reliable transportation, we can help children get to and from school, vocational training, and other learning opportunities
  • We can partner with community organizations and non-profits to provide transportation to literacy programs, job training, and health education resources
  • Working with colleges and universities, we can implement transportation programs for students without a reliable vehicle or other means of transportation
Food Quality & Stability

Food Quality & Stability

According to the U.S. Department of Agriculture, food insecurity—when a household has limited or uncertain access to adequate food supply, resulting in disrupted eating patterns or reduced food intakes—affects an estimated 11.1% of U.S. households. When families and individuals face food insecurity, they are at increased risk of developing chronic disease and developmental issues, and often have higher rates of hospitalization and readmissions.

How can MTM help you address food insecurity among your membership?

  • In areas with limited public transit resources, or for those who aren’t able to use these resources due to their physical or mental status, we can help members get to grocery stores and food pantries
  • Working in partnership with grocery stores and food pantries, we can deliver food supplies to members who have limited mobility due to physical disabilities
Community & Social Contact

Community & Social Contact

When members lack a sense of belonging and engagement due to limited social contact, it often results in social isolation. A Kaiser Family Foundation study found that 22% of U.S. adults say they often or always feel lonely, and that they lack companionship and feel isolated from others.

Socially isolated people—especially seniors—face higher mortality rates stemming from dementia, stroke, and coronary heart disease. They are also more prone to depression, high blood pressure, and cognitive decline, all of which increase medical spend.

How can MTM help you address social isolation among your membership?

  • We can transport members to entertainment and social activities
  • Through partnerships with nursing homes and community care facilities, we can coordinate shuttle services for residents to community activities
  • To help seniors stay connected with their friends and family, we can provide transportation to family events and gatherings
  • Working with non-profit and community organizations, we can provide members with transportation to and from community events