Urban, Suburban, Rural Variations in the Transportation Usage Patterns and Needs Among Older Adults with Multiple Sclerosis

Background   and Purpose: A recent rapid development in the research on senior transportation has contributed to the better understanding of the importance of alternative transportation for older adults with driving difficulties. Still, little is known about whether and how older adults plan to meet their transportation needs after retiring from driving. One of the major reasons for the slow development of knowledge in this area is a lack of data. This study aims to examine the transportation usage patterns, needs, and future plans among older adults with multiple sclerosis (MS), with a focus on urban, suburban, and rural differences.

Methods:  Data come from a nationally-representative sample of adults with MS. We limited our analysis to those aged 65 and over (N=655; 68% Women; 97% White; 73% living with spouse/partner). Transportation usage patterns/needs and sociodemographic and health characteristics were assessed by self-report. A series of logistic regression models were estimated to examine the relationship between residential area and transportation usage patterns/needs.

Results:  Older adults with MS primarily use private vehicles as a driver or passenger regardless of disability. Approximately 28% reported having a permanent disability, but only 5.4% often used disability-specific transportation (paratransit) with a large variation by residential area (9.3% urban, 5.7% suburban, and 1.1% rural areas; p-value=.004). Older adults with MS living in urban areas were more likely to have an access to and to use public transportation compared to those living in rural areas after adjusting for sociodemographic and health characteristics. Surprisingly, approximately 39% expected no change in their transportation in the next 12-24 months, showing their optimistic view regardless of disability.

Conclusions  and Implications: Older adults with MS are a unique group in that the progressive nature of the condition may enable some level of planning for increasing mobility limitations. Understanding the transportation usage patterns, needs, and future plans of older adults with MS would help us to understand how older adults plan their transportation, especially when they expect increasing mobility limitations. The findings of this study imply that a majority of older adults do not proactively cope with transportation challenges even when they have and expect increasing mobility limitations. This might be due to a lack of community resources such as alternative transportation and person-centered mobility management programs. Social workers working with older adults and their families need to pay attention to the transportation needs among older adults, especially those with disability and living in rural areas.