Rural Health and Transportation

Rural Health and Transportation

Access to health care for rural residents brings unique challenges. Rural residents face a longer distance to get to care, but are also seeing great changes in the ways health care is delivered int heir communities. Hospitals are closing at a greater rate in rural America, leading studies to find facets such as decreased ambulatory discharges, a good measure of how many people in the community are receiving regular care. With rural communities continuing to experience population decline, and changes to the health care industry such as practice consolidation, ensuring rural residents have access to care will continue to be a challenge. 

Studies have shown that there are fewer physicians in rural areas to treat health issues. A 2014 study found that there were 53.3 physicians per 100,000 residents in urban areas, but only 39.8 in rural ones. It is also harder for rural residents to access specialized medicine compared to their urban counterparts. A study form the University of Minnesota School of Public Health found that only 46% of rural hospitals had obstetrics care in-house, leading to declines in maternal health. These pressing issues make it more difficult for rural residents to access routine care, which can lead to larger, more costly emergency services in the future. 

For further investigation . . .

Healthcare Access in Rural Communities - Rural Health Information Hub

This resource guide from the Rural Health Information Hub (RHI) contains a wealth of information on the issues faced by rural America in accessing health care services. The guide outlines numerous studies and programs that show the needs as well as potential solutions for health care access in rural communities. 

Getting from here to there: evaluating West Virginia’s rural nonemergency medical transportation program

With funding from the 21st Century Challenge Fund, the West Virginia Rural Health Access Program created Transportation for Health, a demonstration project for rural nonemergency medical transportation. The project was implemented in 3 sites around the state, building on existing transportation systems–specifically, a multicounty transit authority, a joint senior center/transit system, and a senior services center.

Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in DE

Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas.

Additional Resources:

Needham Community Council Rides to Health Care

Needham Community Council – Needham, MA
In 2017, the Needham Community Council began supplementing its volunteer driver medical transportation program with trips provided through the ridehailing company, Lyft. Lyft rides were funded through the Needham Community Council operating budget and a donation from Beth Israel Deaconess Hospital – Needham.

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Engaging Older Adults in Mobility Management

Brookline Council on Aging – Brookline, MA
Transportation Resources Information Planning and Partnership for Seniors (TRIPPS) is an initiative of the Brookline Council on Aging. TRIPPS launched in 2015 with initial funding through a grant from the Massachusetts Department of Transportation using federal 5310 funding. We provide information, resources, and support to older adults in Brookline who are looking for transportation options. Our focus has been on older adults who are either not driving or are transitioning from driving to other modes. About 70 percent of our older adults who we work with do not own a vehicle.

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Seniors on the GO

Gloucester Health Department – Gloucester, MA
Cape Ann Seniors on the GO launched in October 2019 across the communities of Gloucester, Rockport, Essex and Manchester by-the-Sea to meet an identified need of improving access to healthy food and opportunities for physical activity among low income older adults through increased transportation access. This pilot grew out of the work of the Cape Ann Mass in Motion coalition, a part of the Massachusetts Department of Public Health’s Municipal Wellness & Leadership Program. The need for food and physical activity access was identified through root cause analysis and examining high rates of chronic disease among older adults in our Cape Ann communities. Over half of older adults who reside in Gloucester have four or more comorbidities.

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RideLink-Transportation for Older Adults​

Dakota County Community Services, “The Rapid” – Dakota County, MN
RideLink is a network of five area transportation providers that together provide older adults (age 60+) with door-to-door transportation as a complement to the fixed route bus. RideLink can be utilized for medical appointments, shopping trips, and recreational trips, which sets it apart from other options in the area that limit rides for older adults for specific purposes. RideLink’s providers have multiple types of vehicles that provide service to those who use a wheelchair accessible, and also accommodate service animals and caregivers.

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In-House Microtransit in Rural Massaschusetts

Franklin Regional Transit Authority – Greenfield, MA
In 2019, FRTA launched the FRTA Access microtransit program. In contrast to many microtransit programs that are contracted out to a third-party company, FRTA operates its microtransit in house: FRTA upgraded its scheduling software to allow riders to book on-demand rides, and uses its existing demand-response vehicles to make the trips. Eligible demand-response riders have priority when they reserve in advance, and then any remaining capacity is open to the general public through the FRTA Access app. Initially, riders could only summon rides through the app, but over time FRTA also added an online reservation as some parts of the region lack good cell coverage.

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Taxi-Based Employment Program in Partnership with WIB

Franklin Regional Transit Authority – Greenfield, MA
In April 2021, the Franklin Regional Transit Authority (FRTA), which provides transportation in 41 communities in rural Western Massachusetts and fixed-route services in the small city of Greenfield, added a new pilot to expand mobility for workers needing to commute to late night and early morning shifts. In partnership with the local Workforce Board, FRTA received a grant to fund taxi rides for workers needing to get to second and third shift jobs during hours when public transit was not operating. In addition to getting a ride to work, participants could also stop at a childcare facility if they needed to drop off or pick up their children on the way.

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