Ensuring Reliable Transportation for Older Adults in Granville and Vance Counties, North Carolina

This capstone paper examines reliable transportation as a vital condition of health and wellbeing for older adults in Granville and Vance Counties, North Carolina. In these rural communities, limited transportation access functions as a structural barrier that restricts access to healthcare, medications, social interactions, and essential services, contributing to delayed care, increased emergency department utilization, preventable hospitalizations, and social isolation.  To better understand this issue, the project applied multiple public health frameworks and methods, including a rich picture to capture local context, a stakeholder analysis to identify key actors and power dynamics, and a causal loop diagram to examine system interactions and feedback loops. These approaches highlighted transportation as a wicked problem shaped by geographic, demographic, funding, and political contexts.  Building on systems analysis, community health data, and stakeholder input, this project evaluated three options to improve transportation access: Federal Transit Administration (FTA) Section 5310 funding, FTA Section 5311 rural transit funding, and Older Americans Act Title III-B transportation services. Findings indicate that expanding Section 5310 funding is the most effective strategy, as it directly targets the mobility needs of older adults and individuals with disabilities while leveraging existing infrastructure. Strengthening targeted transportation investments offers a feasible approach to improving health outcomes, supporting aging in place, and reducing health inequities in rural communities in Granville and Vance Counties, North Carolina. Keywords: transportation, older adults, aging, rural health, access to care, health equity, aging in place, non-emergency medical transportation, Granville County, Vance County, and Vital Conditions for Health and Wellbeing