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Rural Health Information Hub

Older Adults and People with Disabilities

Transportation can reduce social isolation and enhance individual autonomy and psychosocial well-being. In many rural communities, there is a need for safe, accessible, convenient, and affordable transportation options for older adults and people with disabilities.

Older Adults

Older adults experience barriers to transportation. They may drive less frequently or not drive at all. They may lack access to a personal vehicle, and therefore, need to rely on family members and caregivers or public transportation services. Older adults may also experience physical challenges related to aging, such as visual and mobility impairments, that impact their ability to drive or use public transportation services. A lack of transportation impacts health and well-being due to missed healthcare appointments.

For older adults living in rural communities, these challenges are compounded. It is estimated that approximately 25% of all Americans aged 65 and older live in a rural area of the U.S., and this number will grow as baby boomers continue to age into retirement and as younger populations move to urban centers. Older adults living in rural communities may live far from social contacts, healthcare providers, shopping, community resources, and activities. Additionally, rural communities may lack public transportation.

People with Disabilities

People with disabilities also experience transportation barriers. According to 2018-2022 data from the American Community Survey, the disability rate is 15.3% in rural communities, which is higher than the disability rate in metropolitan areas. People with disabilities living in rural communities often face challenges accessing and using various modes of transportation, which can impact health and quality of life. People with disabilities in rural areas perceive healthcare, businesses, and other types of services as less accessible compared to their urban counterparts, and may need additional support to access transportation both within and around their community. Many healthcare facilities and services in rural areas may not be accessible for people with certain types of mobility-related disabilities.

Transportation programs will need to consider specific accessibility modifications to accommodate the needs of different populations, such as installing wheelchair lifts and ramps, and using accessible vehicles. Rural communities may lack adequate sidewalks and paved roads, which can be a challenge for accessibility. Limited public transportation options create another challenge. In addition, people with disabilities in rural areas may lack information about different transportation options available to them. Transportation programs will need to consider how to best implement appropriate accessibility requirements as well as disseminate information about these programs for different populations.

The National Aging and Disability Transportation Center offers resources to support both older adults and people with disabilities in transportation planning. In particular, when planning medical visits, people with disabilities may need to consider whether their health has changed in a way which will impact their use of different types of transportation. In addition, healthcare providers and staff may need to be involved with helping people to plan their transportation to appointments. Family, friends, and caregivers can also be an important source of information and support for transportation needs.

For some rural residents who have a disability and health insurance through Medicaid, non-emergency transportation for healthcare services can be paid for through Medicaid. This is an important benefit in many areas where people may otherwise go without care.

Resources to Learn More

ADA Guide for Rural Demand-Response Transportation Service Providers
This guide provides an overview of ADA vehicle regulations and service policies.
Organization(s): National Aging and Disability Transportation Center
Date: 10/2014

Health and Transportation
This website provides numerous resources relating to healthcare and transportation services. As the elderly and people with disabilities are prone to utilizing more healthcare services, these resources are especially relevant for these populations.
Organization(s): National Center for Mobility Management

National Aging and Disability Transportation Center
This website provides resources and information for the aging and disabled population's transportation needs, including trainings and webinars, listings of grant and funding opportunities, and other published reports related aging and disability.

Pocket Guide: Planning for Transportation after Medical Services, Rural Edition
This pamphlet is meant to be distributed to elderly and people with disabilities who may require special transportation assistance after a medical service. It emphasizes planning for transportation needs in the rural context and includes referrals to types of organizations that can assist with these issues.
Organization(s): National Aging and Disability Transportation Center
Date: 9/2013

Research and Training Center on Disability in Rural Communities
Offers numerous resources related to disability issues in rural communities. It includes data on disability rates, guidelines on accessibility design, and several publications and educational materials on rural transportation for people with disabilities.
Organization(s): University of Montana Research and Training Center on Disability in Rural Communities