The Role of Transportation in Addressing Social Isolation in Older Adults

Social isolation and loneliness are persistent societal problems, and lead to poorer population health outcomes, greater mortality, and greater health care spending. Older adults face unique risks related to social isolation and loneliness, largely because of the many major life transitions that they are likely to experience, including retirement, death of a spouse, death of other social contacts, and changing health and functional abilities.

Given these many life changes and the diminishing independence that can come with aging, public transportation plays a key role in solutions to address social isolation in older adults.  As the proportion of older adults in American society increases, it is imperative that we design solutions to increase the continued integration of older adults into their community. Robust public transportation, including human services transportation offerings, are an essential component of these solutions, especially for older adults who do not have access to private transportation or who are unable to drive.

Recognizing the importance of this topic and the need to raise awareness on key related issues, the National Center for Mobility Management contracted with the University of Minnesota to prepare a research paper to inform future stakeholder engagement, programs, and policy. 

The University of Minnesota research team investigated the hypothesis that a lack of transportation can be shown to be associated with incidences of social isolation among older adults; specifically, that a lack of mobility directly affects patterns of social engagement by dictating people’s access to resources, amenities, and socializing opportunities. A second part of that premise is that an improvement in older adults’ access to transportation services that fit their needs—with regard to affordability, convenience, and safety—will meaningfully increase their access to life-sustaining activities. The University’s research focused on this research question:  How can public transportation be used as a preventive intervention tool to address the potentially harmful effects of social isolation? 

The resulting research paper summarizes key findings, showcases program examples, and offers recommendations for programmatic, policy, and research interventions to use public transportation to prevent and reduce social isolation and loneliness among older adults.

The following describes key findings from the literature review and key informant interviews:

• Public transportation has a role in addressing social isolation and loneliness
• Social isolation and loneliness are important to be addressed as health issues
• Differences exist in access to and use of public transportation across sociodemographic subpopulations of older adults (e.g., rurality, gender, age, income, disability status, ethnicity).
• Older adults identified issues that shaped their use of public transportation options, such as accessibility; affordability; awareness of their existence and how to use them; limited flexibility of service, especially in rural areas; and constraints on using public transportation for social purposes.
• There is a lack of data and software tools to inform how the use of public transportation might currently be addressing the social needs and preferences of older adults and how it could do so in the future.
• Fragmentation of services (both among transportation providers and between transportation and other sectors) creates a need for expanded collaboration between providers and across sectors to fully meet the needs of older adults.

Given the urgency of loneliness and isolation as public health concerns and the fundamental role that transportation plays in helping individuals to connect with one another, several recommendations emerged from this study that fell into three buckets: additional research, expanded collaboration, and operational improvements.

Additional research

• Collect data on the intersection of public transportation and meeting the social needs of older adults
• Conduct additional research to further inform best practices in providing public transportation to older adults
• Gather and incorporate community input for transportation and public health planning

Expanded collaboration

• Improve collaboration between transportation and public health at the community level
• Increase involvement and coordination between state agencies to align efforts between transportation, aging services, and health.

Operational improvements

• Expand publicly funded options for transportation, including a variety of options that are affordable, convenient, attractive, safe, and accessible for all older adults.
• Broaden the focus of transportation purpose beyond medical transportation to include destinations for social purposes.
• Address public perception and awareness of public transportation among older adults to reduce stigma and increase knowledge.

The research team also identified three case examples (Nevada’s N4 Connect and Ride on Time, Minnesota’s Dakota Area Resources and Transportation for Seniors (DARTS) Loops, and Virginia’s Senior Connections, Ride Connection) that together illustrate several common ingredients for success: cross-sector collaboration and patience in generating it; diverse funding streams; the importance of keeping transportation services affordable; the ability to be nimble in terms of repurposing staff and resources when interventions are not in high demand or piloting program tweaks; and knowing who the client is and what the client needs.

Overall, the research illustrates that the prevalence of social isolation and loneliness among older adults, leads to unnecessary costs, poor health outcomes, and even mortality, requires urgent and coordinated action to ensure that all older adults have equitable access to destinations that support their well-being.