The rise in ride-hail apps and Transportation Network Companies (TNCs) has had mixed effects on public health.
One benefit of TNCs is the enhanced mobility they offer to people who have difficulty driving or navigating public transit, such as seniors and people with disabilities [1], [2]. Access to transportation constitutes a significant obstacle to medical care, particularly for older, lower-income, and non-white patients [3]. Piloted TNC non-emergency transportation initiatives have shown promise in addressing this issue [3]. One study found that ridesharing services make it easier for certain groups—young, low-income, and non-critical patients—to get to the emergency room [4]. Subsidized TNC programs can also help fill gaps in public transit service, providing a way to access medical care and groceries for lower-income travelers [5]. While there is potential for the use of TNC services in transit and special needs ride programs, significant barriers remain. For example, most vehicles cannot accommodate a full wheelchair and require the use of a smartphone app to request a ride [1], [6], [7]. Additionally, drivers may lack training in assisting people with disabilities [8].
Studies have correlated TNC ridesharing availability with decreased fatalities from alcohol-related collisions, particularly if ride subsidy programs are available [9], [10]. However additional research is needed, as there is not a consensus in the literature [11].
Driver health is a significant concern when it comes to TNCs. Health risks include stress, fatigue, musculoskeletal disorders, and urinary disorders [12], and are compounded by job insecurity and the absence of traditional employment benefits [12], [13]. The absence of designated rest areas akin to taxi-stands further exacerbates these challenges [12].

Further research is needed regarding the TNCs’ potential for filling gaps in non-emergency medical transportation, as well as mechanisms to protect driver health and wellbeing.

References

  1. Elizabeth Deakin et al., “Examining the Potential for Uber and Lyft to be Included in Subsidized MobilityPrograms Targeted to Seniors, Low Income Adults, and People with Disabilities,” 2020, doi: 10.7922/g2nk3c9s.

  2. D. P. Mason, Dyana P. Mason, Miranda Menard, and Miranda Menard, “Accessibility of Nonprofit Services: Transportation Network Companies and Client Mobility,” Nonprofit Policy Forum, vol. 0, no. 0, Aug. 2022, doi: 10.1515/npf-2021-0059.

  3. Brian Powers et al., “Nonemergency Medical Transportation: Delivering Care in the Era of Lyft and Uber.,” JAMA, vol. 316, no. 9, pp. 921–922, Sep. 2016, doi: 10.1001/jama.2016.9970.

  4. Saeed Piri, Michael S. Pangburn, and Eren B. Çil, “Impact of ridesharing platforms on hospitals’ emergency department admissions,” pp. 114089–114089, Sep. 2023, doi: 10.1016/j.dss.2023.114089.

  5. Anne Brown et al., “Buying Access One Trip at a Time,” J. Am. Plann. Assoc., pp. 1–13, Jun. 2022, doi: 10.1080/01944363.2022.2027262.

  6. Abigail L. Cochran and Abigail L. Cochran, “How and why do people with disabilities use app-based ridehailing?,” Case Stud. Transp. Policy, vol. 10, no. 4, pp. 2556–2562, Dec. 2022, doi: 10.1016/j.cstp.2022.11.015.

  7. Ruth Steiner et al., “Partnerships between Agencies and Transportation Network Companies for Transportation-Disadvantage Populations: Benefits, Problems, and Challenges:,” Transp. Res. Rec., p. 036119812110326, Aug. 2021, doi: 10.1177/03611981211032629.

  8. Jimin Choi, Jimin Choi, J. L. Maisel, and Jordana L. Maisel, “Assessing the Implementation of On-Demand Transportation Services for People with Disabilities,” Transp. Res. Rec., pp. 036119812110679–036119812110679, Jan. 2022, doi: 10.1177/03611981211067976.

  9. Jessica Friedman et al., “Correlation of ride sharing service availability and decreased alcohol-related motor vehicle collision incidence and fatality,” vol. 89, no. 3, pp. 441–447, Sep. 2020, doi: 10.1097/ta.0000000000002802.

  10. David K. Humphreys et al., “Assessing the impact of a local community subsidised rideshare programme on road traffic injuries: an evaluation of the Evesham Saving Lives programme.,” Inj. Prev., vol. 27, no. 3, pp. 232–237, Aug. 2020, doi: 10.1136/injuryprev-2020-043728.

  11. Noli Brazil, N. Brazil, David S. Kirk, and D. Kirk, “Uber and Metropolitan Traffic Fatalities in the United States,” Am. J. Epidemiol., vol. 184, no. 3, pp. 192–198, Aug. 2016, doi: 10.1093/aje/kww062.

  12. E. Bartel et al., “Stressful by design: Exploring health risks of ride-share work,” J. Transp. Health, vol. 14, p. 100571, Sep. 2019, doi: 10.1016/j.jth.2019.100571.

  13. Saeed Jaydarifard, Krishna N.S. Behara, Douglas Baker, and Alexander Paz, “Driver fatigue in taxi, ride-hailing, and ridesharing services: a systematic review,” Transp. Rev., pp. 1–19, Nov. 2023, doi: 10.1080/01441647.2023.2278446.

Related Literature Reviews

See Literature Reviews on Ridehail/Transportation Network Companies

See Literature Reviews on Health

Note: Mobility COE research partners conducted this literature review in Spring of 2024 based on research available at the time. Unless otherwise noted, this content has not been updated to reflect newer research.