Epidemiology of public transportation use among older adults in the United States

Abstract

Attending healthcare appointments and participating in social activities are important for older adults, but these activities are often limited by transportation barriers. Public transportation may bridge these gaps, but little is known about older public transportation users. This study compares the characteristics of older adults who use public transportation to those who do not. Cross-sectional analysis of data from Round 5 of the National Health and Aging Trends Study (NHATS). We identified 5696 urban, community dwelling older adults, and calculated national estimates of those who reported public transportation use in the last month and those who used transit to see their regular doctor. We evaluated the age and sex-adjusted associations between economic and clinical characteristics and recent use of public transportation using survey-weighted logistic regression. Nearly 1 in 10 (n=555/5696, weighted n=3,122,583) urban-dwelling older adults in the United States reported use of public transportation in the last month, and over 20% of users (weighted n=658,850) relied on transit to see their regular doctor. Compared to non-users, those who reported using transit were significantly more likely to be younger and identify as non-Hispanic Black or Hispanic. Financially strained older adults were more likely to have recently relied on public transportation (adjusted odds ratio [aOR] 1.62, 95% confidence interval [CI] 1.07-2.44), but frailty (aOR=0.61, 95% CI 0.41-0.91) and living in an area with cracked or broken sidewalks (aOR=0.35, 95% CI 0.27-0.46) were both associated with lower odds of public transportation use. More than 3 million older adults in the United States reported recently using public transportation, with over 600,000 relying on these services to visit their doctor. With increasing investment in public infrastructure on the horizon, centering the unique medical, economic, and social needs of older transit users is critical to ensure urban communities remain age-friendly.