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Rural Public Transportation Systems

Rural public transportation systems serve communities outside of urban areas. Types of rural public transportation include demand–response public transportation (dial-a-ride), traditional and deviated fixed route services (e.g., shuttles, circulators), vanpool, or reimbursement programs. The need for rural public transportation has historically been linked with providing mobility and accessibility to essential employment, goods, and services for older adults, persons with disabilities, low-income persons, and others. In reviewing data from 2000 to 2005, APTA found that nearly 9% of public transportation trips were for medical purposes in areas with populations less than 200,000. AARP emphasizes that “access to health care is a key purpose of local public transportation services and rural public transportation programs.”

Rural public transportation services more broadly support well-being for rural residents by also providing transportation to employment, schools, places of worship, and social and recreational destinations. Access to public transportation in rural areas is limited by travel times and distances, frequency of service, cost, and limitations in funding to address these challenges. Mobility Services for All Americans program is a federally administered initiative to improve transportation services and simplify access to employment, health care, education, and other community activities through technology integration and interagency coordination.

Related Transportation and Heath Tool Indicators

How can this strategy result in health benefits?

  • Address chronic disease (e.g., asthma, diabetes, heart disease)
  • Improve access to health-supportive resources
  • Improve equity

How has this worked in practice?

TRIP Everywhere - Riverside County, CA

This Transportation Reimbursement Incentive Program (TRIP) has been in place more than 20 years. It is funded in partnership between the Independent Living Partnership (sponsor), Riverside County Transportation Commission, the Riverside County Office on Aging, foundations, and participating communities. TRIP provides reimbursement for friends and neighbors to transport older adults and persons with disabilities to medical visits and other approved trips. To date, the program has provided 1.6 million free trips totaling 16.1 million miles to more than 5,000 passengers. The program was identified as “the best volunteer driver model in the nation” by The Beverly Foundation in 2009 and received the 2012 STAR (Senior Transportation Action Response) Award.

Where can I learn more?

The National Rural Transit Assistance Program (RTAP) is a Federal Transit Administration program providing a host of technical resources, including toolkits, training, webinars, a resource library, news updates, and information on tribal transit and state RTAP programs.

Federal Transit Administration’s Rural Transit Assistance Program page provides an overview of this formula grant program to provide training, technical assistance, research and other support services, along with information on funding, and a link to guidance on applying for grants for nonurbanized area formula program funding.

AARP’s Livable Communities – Transportation and Mobility site includes a Rural Transportation Toolkit with research and policy briefs on public transportation in rural communities, including statistics, the role of public transportation in livability, funding, health care, and public transportation planning and coordination.

The Transit Planning 4 All program of the Community Transportation Association for America is a partnership with Easter Seals, National Association of Area Agencies on Aging, and Westat to help persons with disabilities and older adults become more involved in coordinated transportation system development. Program activities include conducting surveys, compiling research, providing grants, and establishing a knowledge sharing network.

Evidence base

The American Public Transportation Association (APTA). 2013 Public Transportation Fact Book; 2013.

American Public Transportation Association (APTA). A Profile of Public Transportation Passenger Demographics and Travel Characteristics Reported in On-Board Surveys; 2007.

American Public Transportation Association (APTA). Funding the Public Transportation Needs of an Aging Population; 2010.

Centers for Disease Control and Prevention (CDC), Division of Community Health. A Practitioner’s Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease. Atlanta, GA: U.S. Department of Health and Human Services; 2013.

Oluwoye J, Gooding E. Measuring the Impact of Rural Transit Operations on their Local Economies: A Case Study of Alabama. The Social Sciences 2006;1(3):216–222.

Peng ZR, Nelson AC. Rural transit services: A local economic and fiscal impact analysis. Transportation Research Record: Journal of the Transportation Research Board 1998;1623:57–62.

Stommes ES, Brown DM. Moving rural residents to work. Transportation Research Record: Journal of the Transportation Research Board 2005;1903:45–53.

Syed ST, Gerber BS, Sharp L. Traveling Towards Disease: Transportation Barriers to Health Care Access. Journal of Community Health 2013;Impact Factor:1-28.

Thakuriah VP, Persky J, Soot S, Sriraj PS. Costs and benefits of employment transportation for low-wage workers: An assessment of job access public transportation services. Evaluation and Program Planning 2013;37:31–42.

Transportation for America. Case Studies on Transit and Livable Communities in Rural and Small Town America; 2010.

Transportation for America. Principles for Improving Transportation Options in Rural and Small Town Communities; 2010.

Wallace R, Hughes-Cromwick P, Mull H, Khasnabis S. Access to health care and nonemergency medical transportation: Two missing links. Social Research in Transport (SORT) Clearinghouse; 2005.