# Autonomous Vehicles in Rural Areas: A Review of Challenges, Opportunities, and Solutions
## 1 Introduction  
Rural areas in the US are home to about 20% of the population (with nearly one-quarter of individuals aged 65 and older) and encompass nearly 68% of the nation's road network and nearly 50% of traffic facilities, a significant portion dedicated to the transport of agricultural products, goods, and personal travel [1]. However, the geographic isolation, sparse population, and extended travel distances that characterize rural communities often create unique transportation challenges. These issues are exacerbated by the lack of access to essential services such as healthcare, grocery stores, and public transportation, which disproportionately impacts elderly and low-income residents. With 47% of traffic fatalitiesoccurring on rural roads despite lower traffic volumes, the need for enhanced road safety in these areas is critical. A Governors Highway Safety Association analysis, based on data from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System, revealed that in 2022, the fatality rate in rural areas was 1.5 times higher than in urban areas, with a rate of 1.68 compared with 1.15 [2; 3]. Furthermore, emergency response times in rural regions are more than twice as lengthy as those in urban areas, highlighting significant disparities in transportation safety and access to timely emergency services [4]. The presence of autonomous vehicles (AVs) in rural areas is becoming increasingly important, especially with the growing elderly population in the US and many other countries. The proportion of people aged 65 and older is projected to increase significantly, doubling from 8.3% in 2015 to 17% of the global population by 2055 [5]. However, research on connected and autonomous vehicles (CAVs) has largely concentrated on highways and urban settings, often overlooking the importance and risks associated with rural roads [6]. Data on travel behavior in rural areas are quite scarce, and there is significant uncertainty regarding how AVs impact travel patterns in these regions. The potential deployment of emerging technologies in rural areas could provide promising solutions to enhance the quality of life, safety, and accessibility for underserved populations. These technologies can address challenges posed by rural road conditions, such as steep grades, limited sight distances, and unpaved roads, while overcoming the infrastructure limitations typical of these regions. However, integrating AVs into rural settings necessitates targeted investments in infrastructure, policy adjustments, and community engagement, considering the unique demographic and geographic needs of rural communities. This paper explores the role of AVs in rural areas, addressing the technological, infrastructural, economic, and policy adaptations necessary to make AV deployment feasible and beneficial. By examining recent research, encompassing field tests, simulation studies, interviews, and survey-based studies, this paper offers insights into how AVs could become a viable and impactful solution for rural transportation, thereby improving safety, mobility, and access to essential services. The systematic review in this paper addresses the following questions:  
1. How do AV deployment strategies differ between urban and rural environments? [Section 3.2]
2. What mobility, safety, environmental, and economic benefits could the deployment of AVs bring to rural communities? [Section 3.3.1]
3. What are the key challenges for AV deployment in rural areas? [Section 3.3.2]
4. What infrastructure and technological modifications are necessary for the successful deployment of AVs in rural regions? [Sections 3.3.3 and 3.3.4]
5. What roles do public perception and community engagement play in the adoption of AVs in rural settings? [Section 3.3.5]  
The study provides key insights for policymakers, the automotive industry, and infrastructure operators (IOOs).