The Mobility Crisis in Aging America: How Geography and Disability Shape Access to Transportation

Reliable transportation is essential for maintaining independence, accessing healthcare, and participating fully in community life. Yet for many older adults and people with physical disabilities across the United States, mobility remains one of the greatest barriers to healthy aging. The West Health National Aging Readiness Dashboard, shows that 1 in 5 (21%) adults age 65 and older who live alone lack access to a vehicle, making daily tasks such as medical appointments or grocery shopping increasingly difficult. As the population ages, transportation inequities are widening, particularly for older adults with lower incomes, chronic health conditions, or mobility limitations.

Rural vs. Urban: Unequal Access to Transportation for Older Adults

Where an older adult lives plays a major role in whether they can reliably get to the places they need to go. Data from the West Health National Aging Readiness dashboard shows that transportation barriers are more pronounced in rural communities, where long distances, scarce transit options, and limited specialized services leave many older adults struggling to stay connected. In 2023, 5.9% of rural adults age 60 and older reported that lack of reliable transportation kept them from attending medical appointments, work, or other essential activities, compared with 4.5% of older adults living in urban areas. While the difference may appear small, it reflects a deeper structural divide in mobility access. Older adults in small towns and rural regions often face higher travel burdens, fewer service alternatives, and less access to community resources, making everyday tasks significantly harder to manage. As the population ages, these rural–urban gaps in transportation access are widening, placing rural older adults at greater risk of isolation, delayed care, and reduced independence.

The Growing Challenge of Finding Reliable Transportation for Older Adults

The National Aging and Disability Transportation Center (NADTC) and KRC Research, a public opinion research firm that works with national organizations to study public needs, collaborated on the 2020 survey of transportation providers, which revealed widespread transportation service gaps, especially in rural and low-income communities—where limited coverage, few accessible vehicles, and restricted operating hours make it difficult for older adults with disabilities to travel independently. Providers reported that older adults who rely on mobility devices or require specialized assistance face the steepest barriers because services are often unavailable, inconsistent, or not designed to meet their needs. These challenges are reflected in the survey's finding that “77% of transportation providers say that, for those who do not drive, finding alternative options is difficult,” and that “only 27% say the options are good—and only 3% say very good.” Transportation gaps disproportionately affect older adults with disabilities and those in rural areas. 

In a separate study of riders, NADTC and KRC Research (2018), identifies “accessibility and availability (40%)” as the top barrier and notes that this reflects the rider experience, showing that “most older adults and adults with disabilities would be comfortable using public transportation or specialized services if these options were available and they were aware of them.” For non-drivers, 8 in 10 said lack of transportation prevents them from doing needed activities, often leaving them feeling “dependent, frustrated, and isolated”. Together, the 2020 provider insights and the 2018 rider experiences show that transportation barriers are service challenges, which lead to restricted mobility, health access, and poor quality of life for aging adults across the country. 

Affordable, Accessible Transportation for Older Adults

Solutions must go beyond adding buses or vans; they require redesigning systems with accessibility at their core. Expanding affordable, accessible, on-demand transportation services, such as wheelchair-accessible rideshare and community shuttles, can significantly improve access. Integrating universal design principles into transit planning, such as low-floor buses, curb cuts, audible signals, and real-time digital information, ensures that older adults and people with disabilities can travel safely and independently. Because transportation barriers vary widely across communities, solutions must be tailored to both rural areas with long travel distances and limited transit options and urban settings where service gaps often stem from overcrowding or affordability challenges. 

Partnerships between healthcare systems, local governments, and community organizations can further close mobility gaps. Programs that link transportation assistance with health visits, grocery delivery, or social engagement have been shown to reduce isolation and improve overall well-being.