Determinants of Perceived Transportation Barriers to Opioid Services Among Residents of Alabama’s Black Belt

Transportation can constrain access to opioid-related services in rural communities, yet little is known about how residents perceive this barrier in historically underserved Black Belt communities of Alabama. This study examined the level and correlates of perceived community-level transportation barriers to opioid services among 191 Black adults residing in three Alabama Black Belt communities. Cross-sectional data were collected through self-administered surveys, and multiple linear regression was used to examine sociodemographic, health, interpersonal, and opioid-related correlates. Our findings reported that, on average, participants perceived transportation as limiting community access to opioid-related services about half the time (M = 2.20on a 0–4 scale). Higher depressive symptoms, greater perceived community need for opioid-related services, and greater knowledge of state opioid policies and programs were significantly associated with greater perceived transportation barriers, while lower social isolation was associated with fewer perceived barriers. These findings highlight the importance of addressing structural barriers to improve access to opioid-related services. Interventions such as mobile health units, telehealth services, and transportation assistance programs may help improve service access and health outcomes in underserved rural communities.