Measuring and Improving Seniors' Access to Medical Facilities

Abstract

The travel behaviors of older adults often shift as they retire, begin second careers and make residence location choices geared towards aging in place. Those who rely on transit as their primary mode of transportation can face many accessibility and connectivity challenges when traveling to basic amenities due to their unique travel behaviors and declining mobility with advanced age. First chapter of this thesis focuses on a subset of these travel behaviors through a literature review then evaluates the ability of public transportation to meet the specific mobility needs of older adults (defined in three ways: as those adults >65 years of age, >75 and >85). The ability of transit to provide older adults with access to medical facilities is measured using a pair-wise Transit Opportunity Index (TOI), a comprehensive measure of transit accessibility between origin-destination pairs. In particular, this study focuses on assessing whether seniors in various age groups have better or worse access to medical facilities than the general population. This analysis focuses on CT Transit New Haven, a fixed-route bus system operating in New Haven, Connecticut. Although might be varying based on time of day, the results suggest that seniors within the transit service area have better access to medical facilities than the general population in the same area.\nSecond chapter focuses on access improvement. Equitable access became a concern with passing of non-discrimination requirements specified in Title IV of Civil Rights Act of 1964 and Executive Order 12898 on environmental justice. Increasing need for new methodologies to incorporate equity into network design quickly gained interest of transportation researchers. Although very few methodologies have been developed on the subject, the second chapter builds on available tools on transit network optimization. It develops a frequency setting model for equitable access to medical facilities with respect to elderly population. This research is motivated by findings related to travel characteristics of this particular group, mainly, the time of day of travel and trip purpose. Seniors tend to travel during off peak hours at a rate higher than the rest of the population. Seniors also tend to have a different travel purpose than the rest of the population. Research shows that they make frequent medical trips, along with shopping and running errands all done during off peak hours. Based on the recognition of the need for more frequent service during off peak hours to accommodate the needs of increasing population of seniors’ worldwide, a frequency setting model is applied to the transit network for the City of New Haven, Connecticut. The model is tested on two demand scenarios: a base case in which all demand is treated equally, and a scenario in which a population weight factor is included in the objective function to prioritize the demand of protected populations. Results show improved access by shifting bus frequency to routes serving areas with higher population of seniors.

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