This study examines the impact of transportation on health care access for higher-needs patients and marginalized communities. Through semi-structured interviews with 17 community members facing various forms of marginalization and health challenges, as well as discussions with five global policymakers, the research highlights how transportation factors—such as time, costs, and risks—restrict autonomy and limit access to essential life opportunities. The findings connect these transportation challenges to broader issues like food, education, and health care deserts, revealing that physical barriers significantly influence socio-structural determinants of health. Accessing care often involves additional health risks, compounding existing mental health and injury concerns, particularly for marginalized groups. The study underscores that both mental and physical health care access is linked to urban development and socioeconomic status, suggesting that integrated health care services must consider housing and employment needs. The research concludes with a four-part framework aimed at achieving equitable outcomes in social work, emphasizing the need for a comprehensive approach to health care access.