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Transportation barriers are both a public safety issue and an issue that impacts individual health status. It is important to look at transportation barriers when addressing access to healthcare. A transportation barrier can lead to missed medical appointments, skipping prescription refills, and not engaging with community or recreational activities. When this happens, changes in health status can go unmonitored and cause greater health problems.

Improving transportation resources can help increase the accessibility of medical care as well as increase access to social, vocational, and recreational activities that can improve one's quality of life.

Public (Vehicle) Transportation

Transportation can range from a personal vehicle to a bus, taxi, or train. Para-transport is a special form of public transportation reserved for people with disabilities, which typically run 'door-to-door' services. Cities with public bus routes are required to offer para-transport services that are comparable to the public transportation system and run in a timely and efficient manner.

Rural communities typically lack sufficient standard public transportation options like taxi services and public buses due to limited resources. They also rarely have para-transportation services or coordinated transportation efforts for people with disabilities. Improving transportation in rural communities can be accomplished by coordinating resources. Examples might include:

  • Pool resources to serve a wider population
  • Use para-transit services across multiple communities, combining routes to create wider access
  • Identify funding opportunities and ways to coordinate funding sources to achieve sustainability
  • Create a provider referral system to refer patients to transportation organizations. For example, the HealthTran referral system provides patients with access to affordable transportation organizations that will accommodate disabilities.
  • Beyond public transportation, expand the availability of private transportation options in rural areas, such as taxis, Uber, and Lyft.

Pedestrian Transportation

Walking is a common alternative to motorized transportation, but in rural communities people cannot typically walk to the grocery store for food or to the city center for a medical appointment due to the spread out nature of the community. Lack of safe and accessible pedestrian routes can pose major transportation barriers. In rural communities the pedestrian barriers are not limited to distance between destinations but also include a lack of sidewalks and appropriate handicap accessible curbs outside of buildings.

Methods to improving pedestrian accessibility and safety include:

  • Sidewalks without bumps or cracks
  • Curb cuts
  • Ramps
  • Routes that shorten the distance from place to place

Program Clearinghouse Examples

Resources to Learn More

The ADA & Accessible Ground Transportation
This website, maintained by the ADA National Network, provides a brief overview of ground transportation requirements related to the ADA.
Organization(s): ADA National Network

ADA Guide for Rural Demand-Response Transportation Service Providers
The toolkit booklets explain Americans with Disabilities requirements and regulations for vehicles, service policies, and etiquette for smaller, rural operators.
Organization(s): Easter Seals
Date: 2013

National Aging and Disability Transportation Center
This website provides trainings, webinars, resources, and publications, including a Rural Transportation Topic Guide, with the goal of improving transportation for older adults, people with disabilities, and their caregivers.
Organization(s): National Aging and Disability Resource Center

National Center for Mobility Management
This website provides resources designed to “support Federal Transit Administration (FTA) grantees, mobility managers, and partners in adopting proven, sustainable, and replicable transportation coordination, mobility management, and one call–one click transportation information practices.”
Organization(s): National Center for Mobility Management

National Council on Disability Transportation Update
Provides a national update on the status of disability-related transportation options and future recommendations.
Organization(s): National Council on Disability
Date: 5/2015

National Rural Transit Assistance Program
This website is dedicated to assisting rural communities with developing public and other transit solutions by providing technical assistance, collaboration, trainings, and many resources specific to people with disabilities.
Organization(s): U.S. Department of Transportation and Federal Transit Administration

National Rural Transit Assistance Program: ADA Toolkit
This toolkit goes over the American's with Disabilities Act requirements for transportation and a number of resources to assist rural communities in meeting these requirements.
Organization(s): U.S. Department of Transportation Federal Transit Administration

Transit Cooperative Research Program (TCRP) Synthesis 116: Practices for Establishing ADA Paratransit Eligibility Assessment Facilities
State of implementation of ADA para-transit eligibility, various processes, facilities, equipment, and tools used by transit agencies.
Organization(s): Transit Research Board, Federal Transit Administration
Date: 2015

Transit Cooperative Research Program: Toolkit for Rural Community Coordinated Transportation Services
The purpose of this toolkit is to help rural communities with creating a coordinated transportation system to improve rural resident's ability to access a variety of destinations.
Organization(s): Transit Research Board, Federal Transit Administration
Date: 2004

Transportation to Support Rural Healthcare
This website provides background on rural healthcare transportation, FAQs, and a list of resources to get more information about rural transportation programs.
Organization(s): Rural Health Information Hub