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Rural Health Information Hub

Needs Related to Transportation in Rural Areas

Access to transportation contributes to the economic development, health, and quality of life of rural communities. Reliable transportation is needed for rural residents to access healthcare services, consumer services, employment and educational opportunities, and social services. It is also important for accessing recreation and other activities of daily life.

Healthcare Services

Access to safe and reliable transportation impacts the health and well-being of rural populations. Transportation is necessary for accessing healthcare services in rural communities, particularly in communities where walking or cycling may not be feasible alternatives to reach a healthcare provider. Rural populations rely on personal vehicles, public transport, and non-emergency medical transport to meet their healthcare needs. The American Public Transportation Association reports medical services as the final destination for nearly 9% of public transit riders in small urban and rural areas.

When these forms of transportation are unavailable, unaffordable, or difficult to access, rural community members may not be able to receive important services. Barriers to transportation can result in missed healthcare appointments, delays in receiving healthcare interventions, and missed or delayed use of needed medications—all of which may have negative consequences for managing health conditions. Not having a reliable source of transportation can impact how rural community members make decisions about healthcare. Even when they do have access to transportation, long travel distances can affect their health. For example, care may be delayed to avoid taking time away from work, school, and other commitments.

Employment and Educational Opportunities

Commuting to places of employment is an essential use of transportation services in rural areas. Economic stability for many rural residents is dependent on a reliable means of transportation to a place of employment. In a survey of small urban and rural public transit riders, one report found 34% of all public transit trips accounting for work as the primary destination. For some rural residents, longer commute times and lack of transportation options are common barriers to employment. Existing transportation assistance services may have higher costs per rider in rural areas when compared to urban areas, primarily due to long travel distances and low population densities.

Expanding a communities' access to education improves its economic competitiveness and livability. There is a significant need in rural areas for transportation to and from schools for access to all levels of education. The American Public Transportation Association reports that 12% of all public transit rides are to and from school. Rural children face increased travel time due to the long distances needed to travel to school in rural communities.

Access to Social Services and other Community Activities

Limited transportation options may prevent rural residents from accessing social services and consumer needs (such as running errands or shopping). In more remote locations, transportation may be essential to ensure civic engagement and other types of engagement in community life. Voting for local, statewide, and national elections can be a challenge for those living in rural areas because of limited voting places and transportation options. Tribal populations in particular lack sufficient access to polling places.

Resources to Learn More

National Rural Social Work Caucus
Collection of resources for rural social workers, including relevant journal articles and continuing education. Links to transportation resources are listed under the“Useful Links” tab in the Journal/Resources section.
Organization(s): Rural Social Work Caucus

Transportation to Support Rural Healthcare
Provides an overview of transportation as a social determinant of health in rural communities, as well as resources for developing a transportation program.
Organization(s): Rural Health Information Hub

The U.S. Rural Population and Scheduled Intercity Transportation in 2010: A Five-Year Decline in Transportation Access
Describes the decline in transportation systems that connect rural communities with each other and with urban centers, which is important for employment and healthcare access.
Author(s): Firestine, T.
Organization(s): U.S. Department of Transportation
Date: 2/2011