Sawyer Bowers

Mr$.$ Walden

English $101$

$10$ October $2023$

Left Behind: The Urgent Call to Address Rural Transportation Disparities for Individuals with Disabilities

In the quiet, woods of Six Lakes, Michigan, Phil, a $60-$year$-$old man, confronts a daily reality that is as challenging as it is isolating. Having lost both his legs to type two diabetes, Phil$$s mobility extends no further than the confines of his wheelchair. Recently, Phil had a stroke and is losing function in his left side. The closest specialist capable of addressing his medical needs is in Grand Rapids which is over $50$ miles one way. This $100-$mile round trip is not just a journey across distance, but across a divide of lack of rural transportation.

As the average life expectancy has steadily risen in recent decades, a growing demand for transportation services catering to individual with disabilities has emerged. Urban areas have responded to this need by developing networks and support systems to enhance the well$-$being of community members with disabilities. However, such advancements have not made their way into rural areas which is hindering the way people live. This geographic disparity extends beyond transportation, impacting the overall quality of life for individuals with disabilities. The lack of affordable and accessible transportation options for individuals with disabilities in rural areas, particularly the absence of public transportation for long$-$distance non$-$emergency medical trips to urban areas, raises the concern that people with disabilities may be compelled to live in urban settings due to the primary reliance on expensive and out of pocket medical transportation services in rural regions.

Without the ability to drive and with no family owning a handicap$-$accessible vehicle, Phil$$s options are limited$.$ The absence of public transportation networks in his region transforms what should be routine medical visit into a logistical and financial ordeal. Phil must think about looking into private transportation so he can make it to his medical appointment to ensure his health is in check. Phil finds himself in a financial bracket that disqualifies him from state Medicaid, and he is yet to reach the age threshold for Medicare. Upon researching private transportation options, he realizes that the expense is far beyond his reach. For instance, one service provider charges $$400$ for a round trip of $60$ miles, including an hour of wait time $($Morris$,2019).$ Faced with such steep costs, Phil confronts a distressing dilemma: relocating to Grand Rapids, which would mean leaving his family and familiar surrounding behind or sacrificing the critical medical attention he requires.

The growing need for fair and accessible transportation for people with disabilities in rural areas is an escalating crisis that requires immediate attention. Research conducted by the United States Department of Agriculture Economic Research Service $($USDA$)$ underscores the frustrating reality that individuals with disabilities living in rural America face significant barriers to mobility. The $2013$ American Community Survey highlights that $15\mathrm{.}1\%$ of the rural population live with disabilities, often lacking the basic transportation resources needing for accessing healthcare, employment, and social activities, which are more readily available in urban settings $($USDA$).$ These challenges are compounded by the scarcity of public transportation options that could ease long distance non$-$emergency medical trips to urban centers, further shows the disparities in the quality of life among rural and urban residents with disabilities.

Phil$$s situation highlights a critical issue: the support provided by the State of Michigan for individuals with disabilities, particularly in transportation. The state, through its Health & Human Services department, offers comprehensive financial assistance. This includes fully covering the cost of transportation tickets for those with disabilities. However, residents in rural areas often face significant challenges due to limited or nonexistent public transportation options. To address this, Health & Human Services has implemented a mileage reimbursement program. This program allows individual who assist with medical transportation$-$ including family members, friends, volunteers$$ drivers, foster parents, and employees of commercial or nonprofit medical facilities, as well as services like Dial A Ride and local health departments$-$ to claim $$0\mathrm{.}65$ per mile. Additionally, business operating vehicles with wheelchair lifts for commercial purpose are eligible for the same mileage rate, plus a $$35$ round trip fee $($Health & Human Services$).$ This policy aims to mitigate transportation challenges and provides necessary support to those who need it most but still fails to do so$.$

The scarcity of healthcare professionals in rural regions is a significant factor contributing to lower healthcare utilization rates in these communities. Rural healthca