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This project is twofold. The first part of the project deals specifically with the benefits of multimodal transportation modeling to understand community structure of public health access in a community. Maternal risk and infant outcomes are examined in Kalamazoo County, MI with respect to transportation network accessibility by public transit and private vehicle across the urban-rural continuum. Infants born to mothers just outside the urban core had a higher rate of poor outcomes. Maternal risk factors, by contrast, were associated with the accessible rural areas – areas outside the city proper, but within 30 minutes by car to services. When as much variability as possible (departure time, routes, modes, time of day) was included in the model, very detailed community structure information emerged. This structural information is not specifically causal, but differences in behaviors and use of services, as well as differences in urban poverty and rural poverty were apparent. The second part of the project considered raster-based methods to provide insights into siting intervention locations at efficient and equitable locations for repeating cases of risk – in this case, repeating cases of sexually transmitted infections. The results provide metrics for decision makers to compare intervention locations by efficiency and equity across multimodal optimization.

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TRCLC 17-06