Month/Year of Graduation


Degree Name

Bachelor of Arts (B.A.)


Health, Physical Education and Recreation

First Advisor

Dr. Richard Stacy


The average age of adults in the US is increasing, especially in rural areas. Approximately 60 million individuals live in the rural US, including millions of Medicare beneficiaries. Older rural Americans are more likely to be in poverty, unhealthy, and medically underserved. They rely heavily on government health insurance programs, such as Medicare, to provide for their health care needs. Unfortunately, for many older adults living in rural areas, health care is both difficult to access or in some cases completely unavailable. This is due to several factors, including the lack of specialist care in rural areas (mental health specialists, physical therapists, surgeons), the rising cost of health care, and issues with transportation. Transportation is among the biggest barriers to health care among older adults in rural areas, as rural American communities have gaps in public transportation, older adults start losing driving capabilities as they age, and geographic isolation requires rural residents to travel greater distances to fulfill basic needs such as quality health care, prescription medicines and healthy food. As well as this, rural areas typically lack the infrastructure and connections required to transport people where they need to go, attract quality services to the community, and avail modern technology for in-home support. If older adults can access health care earlier in their lives, it could prevent issues that hurt them in the long run. Because of this, different approaches to transportation must be found. Currently, Medicare provides transportation to primary care appointments through services such as IntelliRide, a non-emergency medical transportation service for those under Medicare or Medicaid. These services are highly beneficial to older adults, but in Nebraska, they are primarily only located in populated, eastern cities such as Omaha or Lincoln. As well as this, transportation is limited to general doctor visits, and occasionally other health care services. The purpose of this thesis is to create a bill that would both expand these services to rural areas throughout central and western Nebraska, offer transportation beyond primary care visits (such as to the dentist or the grocery store), and offer long-distance non-emergency transportation for older adults in rural areas who need specialized care that can only be found in a city.

Included in

Public Health Commons