Gender differences in the use of transportation services to community rehabilitation programs

BACKGROUND Prevention and reduction of disability among community-dwelling older adults have been an important health policy concern in Japan. Moreover, it has also become a gendered issue due to the recent rapid growth in older females than males with disability living in their own homes. The aim of this study is to examine whether there is a gender difference in the use of community rehabilitation programs in Japan, and if so, whether the lack of transportation services and accompanying caregivers are the reasons for the gender difference. METHODS This study was based on surveys of the program administrators and the primary caregivers of the program participants from 55 randomly selected community rehabilitation programs (CRP) in the Tokyo metropolitan area. Questions included sociodemographic characteristics of program participants, types of transportation services provided by the CRP, caregiver's relationship to participant, and the nature of family support. Bivariate statistical analysis was conducted. RESULTS Although there were more females than males with disability residing in communities, our findings showed that females were less likely to use CRP than males (1.3% and 2.3%, respectively; Chi2 = 93.0, p < 0.0001). Lower CRP use by females was related to lower availability of transportation services (36% without transportation service and 46% door-to-door services) and fewer caregivers accompanying the participants to CRP. CONCLUSION This study builds on previous research findings, which suggest gender inequality in access to CRP.