Across the region, there's a big disparity in how long people live. Nearly 90 years, on average, in Indian Hill and Mason, but barely over 60 in Arlington Heights and Adams County. That's nearly 30 years of life, love, children, grandchildren, and memories that are lost. Why? Community health experts are looking at the larger forces that shape health and wellness. The places where we grow up, live, work, and age shape our lives and our opportunities to thrive. This is the fourth story in the series, Health Justice in Action, a year-long deep dive into the factors that people and neighborhoods need for long, healthful lives.You can read other stories in the series here.
At the age of 20, Elijah Powers holds fast to his dream. He wants to share with the world the recipes he’s crafted and create a culinary hub that food lovers will be drawn to. One step in his journey is his job at a small ice cream shop in the quaint Main Street of Williamstown, Ky., 40 miles south of Cincinnati.
“It’s a wonderful place to meet new people,” he says.
As a person with a special needs disability, Elijah will encounter more obstacles than most on his path. But getting to his job at Kentucky Y’all Icebox is no longer one of them. The small, not-for-profit that owns and runs the shop just bought, with the help of a grant, a used Chrysler minivan to ferry Elijah and his co-workers, all people with special needs, to work. Without a car or a driver’s license, and with no public transportation in rural Grant County, getting there might have been an obstacle too big to overcome.
“It’s definitely a big help,” he says.
Most of us take for granted the ease of getting around by car. Need milk, sugar or wine for dinner? No problem, jump in the car and go. Got a commute to the office? Relax in the comfortable sedan or pickup and enjoy the ride while listening to your favorite playlist. But for a sizable number of people, a quick trip in the car is not an option. In the city of Cincinnati,
nearly one in five households (18%) lack any vehicle. In our auto-centric, highway-driven society, that creates inequities and aggravates the already-wide gap between the haves and have-nots.
Compare Cincinnati’s car ownership gap to the status quo in the wealthy suburb of Indian Hill. There, not only does almost every household own at least one car,
more than a third of them (35.9%) have three or more vehicles.
Access to a car or other reliable transportation is essential to keeping a job, going to the doctor, buying groceries, and all the other activities that are part of a healthy, active life. But transportation is not so easy for older adults, people in poverty, and people who are Black. Black women in particular suffer from poor access to transportation. Almost one-quarter of Black women in Ohio (23%)
live in households without a vehicle, compared to 8% of Ohioans overall.
Transportation is critical for good health throughout the course of life. Getting to prenatal care and healthy food
makes for healthier babies and reduces infant mortality disparities. Reliable access to work can
lead to better pay and better physical and mental health. Older adults can
stay in touch with friends and family, health care, volunteer opportunities and other activities necessary for healthy aging.
“Transportation cuts across almost everything that everybody does,” Andy Aiello, Metro’s deputy manager, told participants at a recent Greater Cincinnati United Way-sponsored meeting on the topic. “Whether it's workforce development, or environmental issues, or economic development, it means a lot to our lives, and it means a lot to how successful a community can be.”
In 2020, a majority of Hamilton County voters appeared to recognize this when they agreed to
a major shift in how Metro, Cincinnati and Hamilton County’s main public transportation system, is funded. They agreed to raise the county sales tax to pay for how the bus system is funded, providing another $100 million or so every year for 25 years. The money is paying for several advancements in mobility for those who can’t afford cars, who can’t drive, or who choose not to drive. Those include new 24-hour routes enabling service to the round-the-clock logistics companies at the airport, as well as a pilot project called MetroNow.
That service, currently available in two suburban, lower-income zones in the northern part of the county, provides on-demand transportation within those zones for as little as $2. MetroNow has provided 10,000 rides since its inception, Aiello says. The number-one destination is the grocery store.
“When you talk about health and the needs of populations in certain communities, now we can think about getting on a mobility-on-demand service to get to the store,” Aiello says.
About 20% of MetroNow riders use the service to get to a fixed-route bus stop, giving them access to Metro’s entire system, he says.
As part of its annual $166 million operating budget, Metro receives about $18 million each year in recurring funding from the federal government, and has been awarded between $10 million and $30 million annually in capital funding over the past few years. All of its core federal programs have been funded through fiscal 2025, and the agency has not received any notices of funds being cancelled, a spokesman said.
While Metro’s expansion is helpful to people in the urban neighborhoods of Cincinnati and Hamilton County, getting around without a car in the hinterlands is another story. Public transportation in Clermont County is limited and nearly nonexistent in the more rural corners of the county. That presents a problem for some of the clients of the Clermont Recovery Center, a branch of Greater Cincinnati Behavioral Health Services that provides mental health, addiction, and psychiatric services. Many of its clients lack cars or drivers licenses, making showing up at regular appointments difficult.
“Our county has lots of barriers in accessing the care it needs,” says Heather Cokl, associate vice president of behavioral health services.
Agency leaders decided that if clients can’t make it to the clinic, they’ll take the clinic to them. Using a grant, the agency purchased a 2022 Entegra Coach Odyssey, a 32-foot, Class C recreational vehicle that will be converted into a mobile behavioral health clinic.
Currently, clients need to travel to the Recovery Center’s location outside of Batavia. Now, two case managers will take the mobile clinic on a regular schedule to some of the county’s outlying communities, such as Goshen and Felicity. “We can be present and become a staple in the community,” Cokl says. That will improve access to the mental health care, substance abuse services and other care the clinic provides, enhancing the overall wellness of the community.
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Joe SimonMother and daughter Rachelle Morse, left, and Mona Lazarus run Kentucky Y'all Icebox.The minivan that Elijah Powers can take to work is part of the passion project of Mona Lazarus. She started
DREAM Grant County after a long career as a special education teacher in Grant County Schools. DREAM stands for Disabilities Reframed, Empowered, Accepted and Mobilized. “My goal is to provide meaningful employment to people with disabilities,” she says.
She and her daughter, Rachelle Morse, opened
Kentucky Y’All Icebox on Main Street in Williamstown in March 2024. It now employs ten young adults who have various levels of disabilities. Many didn’t have a reliable way to get to work, so Mona bought the minivan to ferry them.
Patrice Tucker was the first employee hired. She’s a 23-year-old with autism who has experienced difficulty at previous jobs where the supervisors weren’t understanding, says her grandmother. “It’s calm,” Patrice says of her job at the shop. “I like to see people with smiles on their faces.”
Kentucky Y’all Icebox was the dream of Mona and her daughter, Rachelle Morse. “We believe in the dignity of labor for all,” Rachelle says. “We have to think about our labor force,” she says. “Who are we excluding?”
While DREAM Grant County’s small effort makes a huge difference in the lives of its workers, transportation access and workforce health also factor into the mission of BE NKY Growth Partnership, the economic development center in Northern Kentucky.
“Transportation is critically important to economic development,” says Lee Crume, president and CEO of BE NKY. “My clients want really close and quality access to transportation for their goods and services,” says Crume, who works with employers looking to expand or relocate in the region.
It’s just as crucial to employees and to overall community health, he says. “It's important for the workforce to be able to get in and out. When we look at communities and where can we find underserved workforce pockets, transportation is often a gigantic issue for why those communities aren’t being served.”
That's the case in Williamstown, where a three-year-old minivan is going to make a difference for a handful of people who are working to make lives for themselves.
This series, Health Justice in Action, is made possible with support from Interact for Health. To learn more about Interact for Health's commitment to working with communities to advance health justice, please visit here.