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Although lack of access to nonemergency medical transportation (NEMT) is a barrier to health care, national transportation and health care surveys have not comprehensively addressed that link. Nationally representative studies have not investigated the magnitude of the access problem or the characteristics of the population that experiences access problems. The current study, relying primarily on national health care studies, seeks to address both of those shortcomings. Results indicate that about 3.6 million Americans do not obtain medical care because of a lack of transportation in a given year. On average, they are disproportionately female, poorer, and older; have less education; and are more likely to be members of a minority group than those who obtain care. Although such adults are spread across urban and rural areas much like the general population, children lacking transportation are more concentrated in urban areas. In addition, these 3.6 million experience multiple conditions at a much higher rate than do their peers. Many conditions that they face, however, can be managed if appropriate care is made available. For some conditions, this care is cost-effective and results in health care cost savings that outweigh added transportation costs. Thus, it is found that great opportunity exists to achieve net societal benefits and to improve the quality of life of this population by increasing its access to NEMT. Furthermore, modifications to national health care and transportation data sets are recommended to allow more direct assessment of this problem.

Violent crimes against public transit bus operators and passengers in Michigan were studied. The study was funded by the Michigan Department of Transportation and conducted by the University of Michigan in early 1999. A survey approach examined transit passenger perceptions of numerous transit-related crime reduction measures, primarily patrol and security, design actions, and technological innovation. The respondents ranked emergency telephones for passengers and increased lighting as the best crime prevention measures. The survey was part of a wider study that also surveyed transit agencies and transit vehicle operators.

Safety and security are important considerations for the transit operator, but few empirical studies exist that measure the effectiveness of measures taken to improve transit safety either on actual crime (or other incident) data or transit passengers’ perceived safety. The current study focuses on the links between transit safety measures implemented in the Ann Arbor, Michigan, area; the visibility of these improvements to transit passengers; and perceived levels of safety. The findings indicate that the characteristics of passengers’ riding patterns, and whether a safety measure was noticed, all played some role in determining perceived safety. Additionally, ridership patterns and personal characteristics also affected whether passengers noticed safety enhancements. Of the measures undertaken, increased police presence and increased lighting proved most effective in increasing perceived levels of safety, and these also were the most visible. Safety measures also had their largest positive effect on perceptions in association with those transit places and situations perceived as least safe. In a similar vein, although women felt less safe overall than did men, they were more likely to notice safety enhancements and to feel safer as a result. Future efforts to build on this research should incorporate actual crime statistics, thereby extending the models discussed and providing a comprehensive view of the relationships among crime, safety enhancements, and passenger perceptions.