Transportation is the lifeblood of everyone’s day-to-day activity. But if the blood supply for the nation’s hospitals were provided the way transportation for the nation’s aging population is organized, there would soon be lethal shortages. Both systems rely heavily on citizen volunteers, but there is a world of difference between them. Volunteer blood donation is organized at the national level by a single nonprofit organization, the Red Cross, while volunteer efforts to drive older adults are organized one community at a time. Across America, older adults are struggling to find rides for health care, shopping, and basic socialization.
People who stop driving tend to outlive their decision by about a decade, and when they do stop driving, their lives change. The majority of older Americans live in rural or suburban communities that lack the density for traditional mass transportation. When public transit is available, the same functional changes that make driving difficult make public transit equally challenging. What family in America has not worried about a loved one who treasures the independence afforded by driving but is in danger of hurting themselves, or others, and needs to let go of the keys? For many older drivers, it is a Hobson’s choice, deciding between driving unsafely or becoming dependent on favors from family and friends.
The problem is neither small nor inexpensive. By 2030, there will be 61 million baby boomers ages 68 to 84, for whom transportation costs, accounting for 17 percent of household expenditures, will be second only to housing. Will the federal government pay for the rides of older adults who stop driving? According to the Congressional Budget Office, mandatory public spending for people ages 65 or older grew from 5.8 percent of Gross Domestic Product in 2005 to 7.5 percent in 2018, to a projected 9.8 percent in 2029. Mandatory spending for older adults amounted to roughly $1.5 trillion in fiscal 2018, about 85 percent of which was for Social Security and Medicare. Will the public accept adding the cost of transportation to this total?
What about a private-sector solution? Can older adults rely on for-profit services like taxis, Uber, and Lyft? A recent environmental scan of senior ride-hailing services available for older Americans, funded by the Centers for Disease Control and Prevention, found that 70 percent of rides performed by Uber and Lyft were limited to just nine densely populated cities, including New York and San Francisco, and only 4 percent of riders were age 65 and older. Moreover, the independent-contractor labor model used by for-profit ride-hailing companies prohibits them from directing drivers to provide any of the assistance so many older adults require, whether it is an arm to lean on for balance, help carrying packages, or folding a walker.
The nonprofit sector, however, has advantages the for-profit sector lacks. Nonprofits can operate where it’s not profitable for an Uber or Lyft to serve. Nonprofits are not constrained by market forces to serve only densely populated areas, and they succeed in rural and suburban areas in great part because labor is the largest expense in transit, and nonprofits can leverage the invaluable efforts of volunteer drivers.
What’s missing is a unifying nonprofit organization at the national level. Just as the US Armed Forces asked the Red Cross to create and operate a national blood donor program in World War II, our country should create a national volunteer driver program to mobilize Americans to give an older person a ride. With current pent-up demand for access to health care and services as we emerge from the confines of the coronavirus pandemic, now is the time.
The nonprofit sector may be ideally poised to take on the challenge of older-adult transportation, but the best solutions to unmet needs occur when all three sectors of the economy come together — government, industry, and nonprofit. New England is already home to one such convening force: the organization I founded more than 25 years ago, ITNAmerica, which provides technology, research, and operational support to help local nonprofits meet the mobility needs of older adults. Cars and volunteer miles may be traded for credits to pay for future rides. With its specialized software, ITN was specifically designed and built for older adults and people with visual impairments, but it can serve any adult with special needs, with volunteer drivers stowing folding wheelchairs and rolling walkers into trucks and backseats. As a volunteer driver in Portland, Maine, I earned credits, which I transferred to my mother’s ITN account in Connecticut, where another volunteer drove her. In 2005, we rolled out nationally as ITNAmerica, and by 2018, we had delivered a million rides.
Developed through research support from the Federal Transit Administration, technology support from two of the world’s largest technology companies, Esri and Salesforce, and philanthropic support from dozens of foundations, ITNAmerica’s cloud-based platform is now poised to scale to meet the growing need for affordable rides. All that is needed is a national effort to recruit safe, trained volunteers. It can work.
Americans numbering in the millions volunteer to lie down and give their blood away each year. Surely they can also be inspired to give someone’s mother a ride.
Katherine Freund is founder and president of ITNAmerica.