Getting By Without a Car Was Always Hard. Now It’s a Public Health Risk.

When I was ten, I ended up in the local emergency room. I still remember sitting in the waiting room, shaken and in pain, waiting for answers that had evaded the ER doctors and my pediatrician. My mom, in her oversized cat sweater, hugged me when I asked her if I would feel better. I wanted to go home with her, dance to a vinyl record, and make a blanket fort in the living room like we always did when I was sick. Instead, I would need to go to another hospital to see a specialist who focused on autistic kids and other children with developmental disabilities.

My mom couldn’t drive due to her visual impairment, so I only had three transportation options: We could pay more than $100 for an hour-long taxi ride to the hospital, I could wait in the ER for a day or two until they could get a hospital shuttle van, or I could take an ambulance. I grew up in the projects, so my understanding of ambulances was that they came when something really bad happened — when someone was stabbed in a fight, when my neighbor across the street was injured by her abusive husband, when an elderly neighbor had a heart attack, when someone called 9-1-1 on a mentally ill person for shouting at birds. I didn’t want to ride in one, especially not alone.

We eventually decided on the ambulance, even though the idea terrified me, because I was also afraid of staying in the ER overnight or being in the hospital any longer than necessary. The EMTs didn’t use the siren and I pretended I was just in the back of my Poppy’s old truck, which he used to let me ride in if we were only going to the Melrose public pool down the street.

This wasn’t the first time that I had to make a difficult decision because we didn’t have a family car, nor was it the last. I coordinated my SAT testing schedule with friends so that I could drive with them to the test site, and if I wanted to participate in after-school activities I had to pick the ones that ended before the last round of buses left. I walked a mile and a half to pick up new books from the library and drop off the ones I had finished. I made sure every doctor and therapist I went to was within walking distance or on a public transportation route.

During the COVID-19 pandemic, living without a car isn’t just an inconvenience. It’s a public health risk. The CDC is recommending that people drive alone as much as possible, but more than 10.5 million households in this country don’t have a personal vehicle. Many people who don’t have cars are already part of a marginalized group: They’re poor (households with an annual income of less than $25,000 are nearly nine times as likely to have no personal vehicles), disabled (only 65 percent of disabled people drive compared to 88 percent of non-disabled people), or people of color (14 percent of POC households don’t have a vehicle compared to 6 per cent of white households and immigrants across races are even less likely to have a car). Car access is also limited in very urban or very rural areas (54 percent of households in New York City don’t own a car, and more than 1 million people in rural areas don’t have cars).

Many people who don’t have cars are already part of a marginalized group

The transportation options that exist for people without cars were already imperfect — they’re time consuming, don’t cover many areas, and can be inaccessible and unsafe for disabled people and people of color — but they’re even more challenging in a pandemic. Taking public transportation is a risk right now, as is taking a cab or a ride share service like Uber or Lyft (if that’s even an option, since it’s become more difficult to find a ride). At the same time, budgets for public transit across the country have been cut and service has been reduced, making it increasingly risky and difficult for those who do need these services to use them safely and effectively. This combination directly impacts people who don’t have cars, especially people at a high risk of complications from COVID-19 — disabled people and others with underlying and chronic health conditions.

While the pandemic has made many businesses and medical facilities nimble and creative, many have decided to be ‘innovative’ by going drive-through only. Drive-through food, movies, concerts, religious confessionals, haunted houses, even drive-through COVID-19 testing. They all provide convenient opportunities for people who own their own vehicles who want to get out of their homes, but they widen the inequality gap for those who don’t have cars.

Drive-through services are often very literal. One night in my early twenties, I was staying with friends and we found ourselves hungry at 10 p.m. It was close to the end of our biweekly paychecks, and like most broke people, they’d run out of food in the kitchen. The only places open were drive throughs, so we tried to convince the staff at a drive thru to let us order and pay from the window even though we didn’t have a car. Not having a car was a dealbreaker. They said they legally couldn’t serve us or they’d lose their jobs. (While there doesn’t seem to be a specific law addressing this in Massachusetts, in 2016 in Louisiana a blind man sued McDonald’s for not providing him drive-through service when he walked up to the window.) We’d all worked service jobs, so we understood, but we also went to bed hungry.

I’ve had dozens of moments like that throughout my life: Turning down an internship in college because I had no way to get myself there, choosing not to go to the doctor’s because I felt too sick to walk but not sick enough to call an ambulance, asking a friend to help me print out a school assignment because I wouldn’t have enough time to walk to the library to print it myself, calling my best friend to come pick me up when I threw up in the bathroom at work because I had no other way to get home, not applying to jobs because they weren’t on public transit routes and were too far to walk to.

I can’t help but wonder what my mom and I would do if this pandemic happened during my childhood. We’d be facing the same choices millions of Americans have to make now: Do I take an Uber to get to the COVID-19 testing center? Should I cancel my follow-up appointment if I have to get on a bus to get there? Is it safer to take a cab with a stranger or ask for a ride from my neighbor who’s an essential worker? How much will it cost if I call an ambulance to get to the hospital downtown because I’m nervous about taking the train?

No one should have to live this way, especially during a global pandemic.

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