Characteristics of individuals with disabilities receiving transportation services in vocational rehabilitation

1Introduction

Transportation is essential for people of all ages and backgrounds to live a fulfilling and satisfying life. It plays a vital role in many aspects of daily life including access to employment, education, health care, shopping, social occasions, and multiple recreational activities. Put simply, transportation is a requirement for full participation in a community (Jansuwan et al., 2013). Despite the importance, many people in the United States do not have access to adequate transportation, and this experience is disproportionate for people with disabilities. Individuals with disabilities represent approximately 40% of the 15 million people in the United States who have difficulty getting adequate transportation services. Approximately 1.9 million individuals with disabilities report never leaving their home, and 560,000 of these individuals with disabilities indicate problems with transportation are the sole reason for not leaving home (Bureau of Transportation Statistics, 2017).

According to the American Community Survey results (ACS; Lauer & Hountenville, 2017), approximately 41 million Americans experience one or more disabilities, which is equivalent to one out of every eight Americans. People with disabilities travel less frequently and rely on public transportation more than the general population (Penfold et al., 2008). As a result, barriers to public transportation quickly impact the ability of people with disabilities to fully experience their community (Christensen, 2014). Adequate, accessible public transportation is essential to fully address social and economic disparities that exist among individuals with disabilities (National Council on Disability (NCD), 2005). By increasing independence, transportation can serve to mediate these inequalities based upon impairment and subsequently experienced as disability (Aldred & Woodcock, 2008).

Despite removal of many physical barriers within fixed-route systems since the passage of the Americans with Disabilities Act, significant barriers to overall access to public transit systems are still being reported. Barriers to public transportation for people with disabilities are widespread, but documentation in many parts of the country are lacking. A recent report from NCD (2015) provides information from select cities regarding problems and barriers to public transportation for people with disabilities. Problems with fixed-route bus transportation include inoperable lifts and ramps, false claims of inoperable lifts or ramps to avoid boarding a person with a disability, failure to stop for a traveler with a disability, attitudinal barriers among drivers, steep slopes for ramp use, failure to clear wheelchair securement zones for people with disabilities, failure to provide stop announcements, and failure to provide route identification. Problems also exist with fixed-route rail systems including failure to provide level-entry boarding at new or altered stations, lack of an accessible alternative when level-entry boarding is not possible, inaccessible stations and cars, problems with reservations, and failure to provide dual-mode communication in the station or on the track (NCD, 2015).

A recent survey of over 4,161 individuals with disabilities in the U.S. further highlights some of the most prominent barriers to public transportation for people with disabilities. A majority of respondents indicated routes to stops and stations for public transportation were inaccessible (26%), along with inaccessible stops and stations themselves (20%) (Bezyak et al., 2017), which parallel findings from the NCD (2015) and highlight the persistence of these problems. Three out of the top six barriers to public transportation experienced by survey respondents with disabilities were related to characteristics of the driver, including drivers not calling out stops, inappropriate driver attitude, and driver’s lack of knowledge. Alerting passengers to upcoming stops is a necessity for travel and was reported as a barrier by more than 30% of participants. The driver’s lack of knowledge, which was frequently cited as a barrier, encompasses factors such as understanding disability etiquette and needs of specific disability types, alternate communication strategies, and proper use of assistive equipment on public transit vehicles. Climate conditions also represent a significant barrier for many people with disabilities who reside in colder climates. The path of travel to stops and stations, along with the stops and stations themselves, often become inaccessible for long periods of time due to ice and snow. Participants also reported drivers often fail to stop more frequently when ice and snow are present, further impacting the accessibility of public transportation to individuals with disabilities (Bezyak et al., 2017).

A more recent investigation of accessibility of public transportation found individuals with blindness or low vision, psychiatric disabilities, chronic health conditions, and multiple disabilities reported more problems accessing public transportation than other disability groups. Specifically, individuals with psychiatric disabilities, chronic health conditions, and multiple disabilities reported problems accessing public transportation to get to school or work (Bezyak et al., 2019). The authors provided explanations for this finding including an increased reliance on public transportation, which likely intensifies the experience of barriers in this system, and barriers due to problems with cost, reliability, timing, and/or safety concerns.

2Method

3Results

The omnibus test for the model was found to be statistically significant: χ² (71, N = 340,735)=27,327.011, p < .001. The Nagelkerke R² was computed to be .108. The results indicate that all demographic related variables were significant predictors (p < .0001) of receipt of transportation services. The most significant and meaningful predictors, as outlined below, point to important trends in the provision of transportation services.

Results indicate individuals who were unemployed at application were more likely (OR = 2.154; 95% CI 2.105–2.205) to receive transportation services than those who were employed at application. In addition, individuals referred by a welfare agency were more likely (OR = 1.285; 95% CI 1.213–1.361) to receive transportation services than those who were self-referral, and individuals receiving TANF at application were more likely (OR = 1.530; 95% CI 1.461–1.604) to receive transportation services than those who did not receive TANF. With attention to living arrangements, individuals living in rehabilitation facilities, homeless shelters or substance abuse treatment centers were more likely to receive transportation services than people who live at home. The odds for (a) people living in homeless shelters was 2.278 (95% CI 2.137–2.428); (b) rehabilitation facilities was 2.274 (95% CI 2.050–2.522); and (c) substance abuse treatment centers was 1.692 (95% CI 1.583–1.808).

Additional predictive relationships found include individuals from racial and ethnic minority backgrounds were more likely to receive transportation services than individuals who are White, with odds ratio of 2.099 (95% CI 2.050–2.148) for Hispanic and 1.478 (95% CI 1.451–1.505) for Black. When investigating disability type, individuals with alcohol and drug abuse problems, mental health disorders, and HIV/AIDS or other immune deficiency disorders were more likely to receive transportation services than people with other impairments. The odds for (a) HIV and AIDS was 3.575 (95% CI 3.159–4.047); (b) drug abuse or dependence (other than alcohol) was 2.172 (95% CI 2.072–2.277); (c) alcohol abuse or dependence was 2.129 (95% CI 2.010–2.254); (d) depressive and other mood disorders was 1.971 (95% CI 1.904–2.040); (e) anxiety disorders was 1.890 (95% CI 1.797–1.987); (f) personality disorder was 1.881 (95% CI 1.756–2.016); (g) immune deficiencies excluding HIV/AIDS was 1.794 (95% CI 1.490–2.161); (h) mental illness (not listed elsewhere) was 1.779 (95% CI 1.679–1.884); and (i) schizophrenia was 1.711 (95% CI 1.630–1.795). The complete result of the logistic regression analysis is presented in Table 2.

4Discussion

Adequate transportation is essential for individuals with disabilities to fully experience community and live a satisfying life (Christensen, 2014). Despite the importance, many people with disabilities do not have access to adequate transportation. In fact, nearly 560,000 of individuals with disabilities indicate problems with transportation are the sole reason for not leaving home (Bureau of Transportation Statistics, 2017). Access to transportation is essential for individuals with disabilities to increase independence and begin to resolve social and economic disparities, including opportunities for employment (NCD, 2005). The purpose of the current study was to further examine the use of transportation services among individuals with disabilities in pursuit of employment and identify predictors of the receipt of these services in vocational rehabilitation programs in order to better address systematic barriers and develop lasting solutions.

Multivariate logistic regression analysis was used to detect predictors of the receipt of transportation services among individuals with disabilities who were actively pursuing employment opportunities. Results highlight trends that are supported by previous research and can lead to improvements in policy and provision of transportation services for people with disabilities. For example, individuals who were not employed, who were receiving welfare, and/or who were receiving TANF were more likely to receive transit services from vocational rehabilitation programs. In addition, people who were homeless, living in rehabilitation facilities, and/or living in substance abuse treatment centers were more likely to receive support with transportation from vocational rehabilitation personnel. Previous research documents the significance of transportation as a barrier to employment for people with disabilities (Sabella & Bezyak, 2019), and the provision of transit services and/or support can aid in overcoming certain barriers to transportation. Cost and availability of services have been identified as specific barriers in the public transportation system for individuals with disabilities (Bezyak et al., 2017), and individuals who are unemployed, receiving welfare and/or TANF, or are experiencing homelessness likely experience these types of barriers. The provision of transit services by vocational rehabilitation agencies helps address such barriers and assists in the pursuit of employment for these individuals.

Results also indicate that individuals with disabilities with substance use problems, mental health disorders, and/or HIV/AIDS or other immune deficiency disorders are more likely to receive transit service support from vocational rehabilitation programs when compared to people with other impairments. Previous research supports these claims and reveals individuals with psychiatric disabilities and chronic health conditions experienced more barriers to accessing public transportation than other disability groups, and both these groups indicated problems with transportation when going to work or school (Bezyak et al., 2019). Barriers include cost, reliability, transfers or timing of services, difficulty planning routes, and safety concerns. Support from vocational rehabilitation helps overcome barriers including cost and concerns related to timing and planning of routes, which then improves the likelihood of obtaining successful employment.

Individuals from racial and ethnic minority backgrounds also had a higher likelihood of received transit services from vocational rehabilitation agencies. Bezyak et al. (2019) found people with disabilities identifying as Hispanic, Latino/a, and Spanish origin reported more problems using fixed-route transportation for education and employment-related travel, among other types of travel. These barriers may be a product of cultural and language access issues, which result in more extensive transportation barriers, and disparities in income, employment, and education are well-documented for minority groups (U.S. Department of Health and Human Services, 2012). The provision of transit services at a higher rate to individuals of racial and ethnic minorities by vocational rehabilitation services may begin to address such disparities with attention to employment.

5Conclusion

Employment is crucial to the health and well-being of individuals with disabilities and promotes a more fulfilling and satisfying life. Lack of transportation is a major barrier to finding and retaining employment. Despite the obvious necessity of accessible and reliable transportation, barriers to public transportation for individuals with disabilities are significant. In order to allow individuals with disabilities to begin to overcome such barriers, vocational rehabilitation organizations should provide transit services for individuals with disabilities when pursuing employment. Results of the current study indicate individuals who are unemployed, receiving welfare and/or TANF, living in rehabilitation and treatment facilities, and are homeless are more likely to receive transit services through vocational rehabilitation. Specific disability types and racial/ethnic minorities were also identified as more likely to receive supports surrounding transportation. As previous research provides support to these results, it becomes clear that improvement in transportation services for individuals with disabilities is needed on a systems level and an individual level as well. Advocacy efforts, education, and increased awareness are needed to fully understand the impact of a disability on the individual’s ability to use public transportation. The public transportation system can serve as a gateway to countless opportunities for people with disabilities, but without adequate attention and funding to address the numerous and significant barriers, public transportation will continue to impede employment efforts for people with disabilities. State rehabilitation counselors can evaluate the extent high-risk clients identified in this study can benefit from transit services as well as other wrap around services that can improve their engagement in VR services leading to better employment outcomes.