Dialysis, Doctors, and Other Destinations in Rural Tennessee: A Comparative Analysis of Demand Response Transportation Trips by Age, Gender, and Disability Status

Transportation-disadvantaged populations, including older adults and people with disabilities, often have limited transportation options. In rural areas, these populations are crucially reliant on demand response transportation (DRT) to meet their basic needs. Rural DRT operators are often challenged by high demand and limited funding, necessitating a clear understanding of the specific needs and travel behavior of these riders for effective service planning. This research evaluated 2 years of DRT trip records (over 200,000+) from the rural Upper Cumberland region of Tennessee to provide a detailed evaluation of the travel behavior of different demographic groups (age, gender, and disability status) by trip purpose. A spatial analysis and statistical tests were performed. Overall, medical trips were the most common trip purpose (35.7%). Despite typically being combined, medical and dialysis trips showed very different trends; dialysis showed travel peaks 3 days per week, three times per day. Employment trips were the second most common trip purpose (25.4%) and had peaks at 6:00 a.m. and 3:00 p.m., suggesting shift-based work. Senior center trips (4.2%) showed three distinct peaks, owing to riders leaving after morning and afternoon activities. One last trend showed that, of all demographic groups, the travel of riders with disabilities varied most. They traveled farther for employment and dialysis trips, left senior centers earlier, and had more concentrated peak travel. These findings suggest relatively consistent spatial and temporal trends by trip purpose, which could help DRT operators and transportation planners in rural areas better meet the needs of their riders.