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Abstract
The number of Americans age 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, and the 65-and-older age group's share of the total population will rise from 16% to 23% (US Census 2018). Also, average U.S. life expectancy increased from 68 years in 1950 to 78.6 years in 2017, in large part due to the reduction in mortality at older ages. This larger share of older adults also means that Social Security and Medicare expenditures will increase from a combined 8.7% of gross domestic product today to 11.8% by 2050 (Social Security Administration 2019).
These societal changes among aging Americans, along with the current COVID-19 pandemic, have led to isolation on a greater scale than in recent times. This is especially true in the rural area where small urban and rural communities continue to age as disproportionate shares of the younger population move to larger communities pursuing education, employment, and other opportunities.
The objective of this research was to quantify the cost of providing greater mobility through public transportation to aging adults in small urban and rural communities to lower social isolation. This was compared with the increased medical spending due to current levels of isolation. Effort was taken to quantify the costs in numerous states throughout different regions of the United States.
Results for the states studied showed that from three to 10 trips per month could be provided to an isolated individual at a lower cost than the extra medical costs due to isolation. Also, an extra 25 to approximately 80 miles of service can be provided to an isolated aging adult per month for the states studied. Finally, from two to six hours of service can be provided to an isolated aging adult per month at costs equal to or less than the monthly medical costs due to isolation. A marketing plan designed to target potential aging and isolated riders showed that the simulated cost of seven monthly trips per passenger would be feasible for small, medium, and large agencies at the median level, and that all simulations yielded cost-effective results for medium-sized agencies when added marketing and operating costs were included in the simulations.