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Data: National Equity Atlas, IPUMS USA; Note: Race/ethnicity groups with insufficient data are not shown; Chart: Axios Visuals

More than one in five U.S. adults without access to a vehicle or public transportation missed or skipped a medical appointment last year, according to a report by the Urban Institute.

Why it matters: While access to telehealth has reduced some transportation barriers, it's not available to all and can't replace in-person care for all medical needs.

In the Portland area, 8% of all households — and nearly 24% of Black households — don't have a car.

Despite Portland being known for its public transit and bikeability, one of the primary ways to traverse the city is by car.

What they found: Nationwide, 21% of adults without access to a vehicle or public transit said they went without needed medical care in 2022.

Though 91% of adults reported they had access to a vehicle, the figure was substantially lower for Black adults (81%), those with low family incomes (78%) or a disability (83%) and for people with public health insurance (79%) or no coverage (83%).

Go deeper: Research suggests as much as 40% of a person's health can be attributed to socioeconomic factors like education, employment and the availability of transportation.

The pandemic heightened awareness of racial inequalities, prompting some cities to ensure there's more equitable access.

How transportation impacts health in Portland

Research suggests as much as 40% of a person's health can be attributed to socioeconomic factors.

Health care

More than one in five U.S. adults without access to a vehicle or public transportation <a class="gtmContentClick" data-vars-link-text="missed or skipped" data-vars-click-url="https://www.axios.com/2023/04/28/over-skip-health-care-transportation-barriers" data-vars-content-id="125ae04d-b8b8-4a9d-b48d-9071a33040a7" data-vars-headline="How transportation impacts health in Portland" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/04/28/over-skip-health-care-transportation-barriers" target="_self">missed or skipped</a> a medical appointment last year, according to <a class="gtmContentClick" data-vars-link-text="a report" data-vars-click-url="https://www.rwjf.org/en/insights/our-research/2023/04/more-than-one-in-five-adults-with-limited-public-transit-access-forgo-healthcare-because-of-transportation-barriers.html" data-vars-content-id="125ae04d-b8b8-4a9d-b48d-9071a33040a7" data-vars-headline="How transportation impacts health in Portland" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.rwjf.org/en/insights/our-research/2023/04/more-than-one-in-five-adults-with-limited-public-transit-access-forgo-healthcare-because-of-transportation-barriers.html" target="_blank">a report</a> by the Urban Institute.Why it matters: While access to telehealth has reduced some transportation barriers, it&#x27;s not available to all and can&#x27;t replace in-person care for all medical needs.

Health

Transit

Seizures of psilocybin mushrooms ("magic mushrooms") by law enforcement rose in Oregon and across the country from 2017 to 2022, according to a study by the National Institute on Drug Abuse.

Why it matters: While a regulated market for psychedelic fungi exists in Oregon, police are still targeting the black market of recreational users.

By the numbers: Oregon ranked eighth in the country for confiscations during that six-year period, with 182.

Between 2017 and 2022, Oregon's annual mushroom seizures rose to 41, an increase of 105% — the 21st biggest increase in the nation.

Zoom out: Nationally, law enforcement recorded 1,396 psilocybin mushroom seizures in 2022, up from 402 in 2017, reports Axios Denver's Esteban L. Hernandez.

Context: The study's time frame includes periods before Oregon became the first state to legalize psilocybin for therapeutic use in 2020 with the passage of Measure 109.

The first treatments at service centers began in mid-2023.

Flashback: Measure 110 decriminalized small amounts of most recreational drugs in 2020, including psilocybin, but lawmakers are already rethinking that law.

Of note: Licensed growers may not retail the mushrooms and can only sell to licensed service centers.

Be smart: The states and regions where seizures are reported don't necessarily reflect the fungi's intended destinations, according to the study's authors.

The intrigue: The findings could signal that more people are using psilocybin for nonmedical or recreational use.

Psilocybin is thought to be the most-consumed plant-based psychedelic, with 11.3% of people age 12 and over reporting having ever used it in 2022.

What they're saying: Joseph J. Palamar, lead author on the study and an associate professor at the NYU Grossman School of Medicine, told Axios by email:

"The positive media coverage about the drug's medical benefits might be contributing to people's willingness to use it."

What's happening: Nathan Howard, director of operations at InnerTrek's Center for Psilocybin Services in Portland, said psilocybin is having a cultural moment nationally for several reasons.

Half a century after the beginning of the war on drugs, "you have people just begging for their life for something different than alcohol for recreation, which is poisonous, unlike mushrooms, and begging for something that gets to the root cause of their unhappiness," he told Axios.

Howard said the movement welcomes expanded legal, therapeutic use of psilocybin, such as in Oregon and Colorado, as well as reclassification by the U.S. Food and Drug Administration.

He compared the underground use of mushrooms containing psilocybin to quilting. 

"People make them and give them to their friends."

Magic mushroom seizures are up in Oregon

Psilocybin mushroom grown in a cultivation facility in Littleton. Photo: Courtesy Hyoung Chang/The Denver Post via Getty Images

Seizures of <a class="gtmContentClick" data-vars-link-text="psilocybin mushrooms" data-vars-click-url="https://www.axios.com/2023/07/19/mushrooms-cannabis-mental-health-treatment" data-vars-content-id="35584c9c-c62b-4189-a581-2846b7c0018c" data-vars-headline="Magic mushroom seizures are up in Oregon" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/07/19/mushrooms-cannabis-mental-health-treatment" target="_self">psilocybin mushrooms</a> (&quot;magic mushrooms&quot;) by law enforcement rose in Oregon and across the country from 2017 to 2022, according to a study by the <a class="gtmContentClick" data-vars-link-text="National Institute on Drug Abuse" data-vars-click-url="https://nida.nih.gov/news-events/news-releases/2024/02/law-enforcement-seizures-of-psilocybin-mushrooms-rose-dramatically-between-2017-2022" data-vars-content-id="35584c9c-c62b-4189-a581-2846b7c0018c" data-vars-headline="Magic mushroom seizures are up in Oregon" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://nida.nih.gov/news-events/news-releases/2024/02/law-enforcement-seizures-of-psilocybin-mushrooms-rose-dramatically-between-2017-2022" target="_blank">National Institute on Drug Abuse</a>.Why it matters: While a regulated market for psychedelic fungi exists in Oregon, police are still targeting the black market of recreational users.

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A slope chart showing the share of Americans who say they trust childhood vaccine recommendations set by the government, from a poll conducted in June 2025 and March 2026. The share who agreed decreased from 71% to 60%, while the share who disagreed increased from 28% to 39%.

Share of Americans who say they trust childhood vaccine recommendations set by the government

Data: Axios/Ipsos; Note: Margin of error is ±2.9 percentage points; Chart: Axios Visuals

What Americans sacrifice due to high health costs

A bar chart that shows the share of U.S. adults who say they've postponed life events because of health costs in the last four years. Taking a vacation ranks highest at 29%, followed by surgical or medical treatment at 26%. Having or adopting a child is lowest at 6%.

Adriel Bettelheim

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