Paratransit as a vehicle for reducing loneliness and social isolation among adults and older adults

Abstract

Introduction

Paratransit, a form of federally-mandated demand-responsive transit (DRT), provides crucial mobility options for persons living with disabilities and older adults across the United States. The social connections that these paratransit trips enable is theorized to decrease social isolation and loneliness, thereby improving cognitive and mental health outcomes of riders. However, there exists very little direct evidence for the effect of transportation on loneliness among older adults. This study investigates the association between mobility and self-reported social isolation among older adults riding paratransit in Pinellas County, Florida.

Methods

Leveraging a novel methodology that paired 1276 digitized travel survey responses with hyper-granular trip data relating to each response, we examined how paratransit usage influences the social connectivity of paratransit riders. We assessed the extent to which PSTA's paratransit service is associated with a self-reported improvement in loneliness among adults and older adults, and the links between socio-demographics, travel patterns and loneliness.

Results

67 % of adults and 71 % of older adults reported feeling less lonely after using paratransit, with particularly strong benefits observed among low-income users and those with disabilities. Spatial analysis revealed that high loneliness improvement rates were concentrated in areas near community centers, parks, and social hubs, while trips to healthcare facilities and casinos showed lower improvements. We estimate that each paratransit trip resulted in 2.7 new social connections, which could lead to reduced loneliness and isolation, and a decrease in related health conditions. Using an existing theory of change (ToC) model tailored to loneliness, we estimate that PSTA's paratransit service has resulted in healthcare savings in excess of $230 million over a three-year period.

Conclusions

Extrapolated nationally, paratransit could be generating $94.1 billion of cost savings annually, or ∼2 % of the US total healthcare spend. Paratransit should therefore not be seen solely as a transportation mode, but also as a strategic investment in public health and wellbeing.