Structural
GPS-Derived Mobility Profiles and Neighborhood Context Among Transwomen of Color in New York City: The TURNNT Cohort Study Giselle A. Barreto* Giselle Barreto Barreto Barreto Barreto Barreto Barreto Barreto Florida International University
Transwomen of color (TWOC) face barriers in healthcare engagement due to neighborhood structural conditions. Traditional residential measures overlook broader environments experienced daily. Global Positioning System (GPS)-derived activity spaces provide a more practical picture of neighborhood exposure, but the impact of structural disadvantage, safety, and service access on mobility, especially for TWOC, remains less understood. We examined how weighted census tract characteristics (assessed with GPS activity spaces) shape mobility profiles among TWOC in New York City. We identified latent mobility profiles using one week of GPS data collected at baseline (2020–2023) from 130 TWOC aged 18–55. Adjusted odds ratios and 95% confidence intervals were estimated using logistic regression (SAS 9.4), considering factors such as socioeconomic disadvantage, socio-structural vulnerability, crime, and availability of healthcare providers collected from public census and municipality data. Two profiles emerged: short-range movers with localized activity spaces and long-range movers who traveled across more census tracts and greater distances. After adjusting for demographic characteristics, participants who spent more time in census tracts with greater socioeconomic disadvantage and socio-structural vulnerability had significantly higher odds of short-range mobility (aOR = 2.98, 95% CI: 2.56–3.46 and aOR = 1.57, 95% CI: 1.38–1.80 respectively). However, a lower odds of short-range mobility was associated with greater time spent in areas with higher levels of crime, including violent crime (aOR = 0.36, 95% CI: 0.30–0.43) and nonviolent crime (aOR = 0.29, 95% CI: 0.24–0.35). Similarly, those who spent more time in areas with below-median availability of trans-competent healthcare services (aOR = 0.27, 95% CI: 0.23–0.30) and primary care providers (aOR = 0.85, 95% CI: 0.74–0.98) also had lower odds of short-range mobility. Short-range mobility appears rooted in areas marked by socioeconomic disadvantage, while long-range mobility reflects movement through higher-crime and lower healthcare service neighborhoods. These patterns reveal how mobility reflects neighborhood opportunity structures and shapes differential exposure to structural barriers that may impede healthcare engagement.