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1Traffic and Transport for an Ageing SocietyDr. Charles Musselwhite
Reader (Associate Professor), Swansea UniversityRoom 309 Vivian Tower Email: [email protected]
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Overview Are older drivers safe on our roads?
Do we need to test them further?
How safe is the walking environment
How can we improve it?
Are buses good for our health?
Is it worth investing in a free bus pass for older people?
Conclusion
Mobility and health and wellbeing
Being mobile in old age is linked to quality of life (Schlag et al. ,1996).
In particular, giving up driving has repeatedly been shown to related to – a decrease in wellbeing – an increase in depression and related health
problems, – feelings of stress, Isolation and – increased mortality – (Edwards et al., 2009;Fonda et al., 2001;
Ling and Mannion, 1995; Marottoli, 2000; Marottoli et al., 1997; Mezuk and Rebok, 2008; Musselwhite and Haddad, 2010; Musselwhite and Shergold, 2013; Peel et al., 2001; Ragland et al., 2005 Windsor et al. 2007; Zieglar and Schwannen. 2013).
Ex-drivers who depend on others for a lift nearly twice as likely to go into long-term care, as compared with older people who were still driving (Marottoli, 2000).
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Are older drivers safe on the roads?
What physiological changes happen in later life that might influence driving behaviour?
Might they result in crashes?
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Physiological changes
increased fatigue;
poorer reactions – (for example, on average, drivers over 55 take 22% longer to react
than drivers under the age of 30 years) (DfT, 2001);
difficulty with glare and luminance – (average recovery time from glare, from lights from other vehicles or
low sun for example, at age 16 is 2 seconds whereas at age 65 is 9 seconds and 75 year old driver requires 32 times the brightness to be able to see the same scene they did at age 25) (DfT, 2001) and;
difficulty keeping a consistent constant speed – (difficulty in detecting changes in feedback from the vehicle speed
and difficulty in keeping foot pressed to the floor in the same position for long periods of time) (Musselwhite and Haddad, 2010).
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Types of collision
Clarke et al. (2009) reviewed STATS19 data (police on-scene incident record) and found older drivers are over represented in collisions:– at Junctions;– in merging traffic;– with right-hand turns (when driving on the right-hand
side of the road) and;– in busy traffic (see Clarke et al., 2009 for review)
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Increase in KSI 75+
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Frailty?
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Low miles
Private transport is embedded in the socio-political fabric of capitalism
Over reliance on statistical analysis driven by those who have most to benefit force hyper-mobility through reductionalist modernist principals.
Building has created more demand, more desire to use.
Costs are forced onto the users (and non-users) and away from business and organisations as businesses conglomerate and maximise profits (savings of money).
Disproportionate costs between winners and losers (white motorways through black bedrooms -Mugyeni and Engler, 2011)
At the expense of individualism, humanism, society, community, health, safety and beauty.
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Responsibility
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Compensation Drive slower
Take breaks
driving when conditions suit them – low sun – heavy rain – Snow and ice– dark – rush-hour
acquiring vehicles to suit their needs (tall vehicles, with much vision, stiff ride with noticeable feedback and buying vehicle with power steering, automatic gears)
Avoid roads they feel uncomfortable with – not using motorways (largely due to the merging traffic)– not taking difficult turns across traffic,
(Baldock et al., 2006; Holland, 2001; Musselwhite and Haddad, 2010; Musselwhite and Shergold, 2013; Rabbitt et al., 1996; Rabbitt and Parker, 2002).
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But do they know what their problems are?
How self-aware are they as drivers?
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But do they know what their problems are?
How self-aware are they as drivers?
Charlton, et al. (2001) Cushman (1996) and Marottoli and Richardson (1998) suggest older people are not very good at judging their own ability; they may generically feel more vulnerable but this does not equate well to actual driver ability (Rabbitt et al., 1996).
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Should we give older drivers extra testing of their ability?
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Evidence
Positive results:- Eye test
– Levy et al (1995) (across US states)
– McGwin et al (2008) (Florida)
Restrict licence– Nasvadi and
Wister (2009) – British Columbia
Grabowski et al (2004)
USA – Vision tests, road tests, more frequent licence renewals, in person renewals no difference
Langford et al (2008) Victoria (no age controls) and New South Wales (medical assessment 80+ and on road test 85+)
No sig diffs for older or other road users
Mitchell (2008) Across Europe lowest fatality rates for this age group occur in two of the countries (UK and the Netherlands) with more relaxed procedures
Siren and Meng (2012)
introduction of age-based cognitive screening starting from the age of 70 in Denmark in May 2006, in a population-based study.
Whilst collision rates for car drivers did not significantly change across any age group. the collision rate for older vulnerable road users in the post-implementation period increased significantly: by 38%.
Langford et al., (2004).
In Sydney (where there is mandatory assessment from 80 years onwards) and Melbourne (in which there are no age-based controls)
older drivers in Sydney (with age-based controls) had higher collision risks per licence and per times spent driving than those in Melbourne (who had no controls).
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Improving active travel
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Problems with being a pedestrian
Older people represent around 16% of the population, yet around 43% of all pedestrians killed (DfT, 2009).
Changes in physiology: slower movements, less able to change gait, poorer eyesight, lack of confidence (esp in light of previous falls (see Dunbar et al., 2004 for review).
Older people report issues with being a pedestrian – lack of time to cross the road at formal crossings, 85% of men
and 91% of females don’t walk at required 1.2m/s as per DfT guidance (Musselwhite, 2015)
– cracked or uneven pavements or kerbs at formal and informal crossings,
– poor quality paths, – lack of amenities (especially benches and toilets), and
unattractive, unwelcoming and inapproachable spaces (see Alves et al., 2008; IDGO, 2013, Musselwhite, 2011).
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If we reduce pedestrian and cycling casualties there are wider benefits to active travel
Encouraging local community – roads create hypermobility and severance of communities
Physical and mental health benefits of active travel
19Implications for healthFewer people walking and cycling
which is vital for health
Created an “obesogenic” environment (Roberts and Edwards 2010) with fewer and fewer people walking.
Walking can also improve mental health and well-being, by having a positive impact on self-esteem, physical self-worth (McAuley et al., 2000), stress, mood and mindset (Roe and Aspinall, 2011).
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Building roads creates Severance
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Appleyard and Lintell (1972) studied three San Francisco streets with different levels of road traffic and asked residents about the number of friends and acquaintances they had on street
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Hart, J. (2008). Driven to Excess. Masters thesis. University of the West of England http://www.walk21.com/papers/Josua_Hart.pdf
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Hart, J. (2008). Driven to Excess. Masters thesis. University of the West of England http://www.walk21.com/papers/Josua_Hart.pdf
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Hart, J. (2008). Driven to Excess. Masters thesis. University of the West of England http://www.walk21.com/papers/Josua_Hart.pdf
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How do we do it?
Emphasis on improving environment
Human/social approach to streets– Places in themselves not movement corridors
Use CABE guidelines?
Improving the streetsLeading to:
Time to share the streets?
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Improving the streets as places “People have always lived on streets. They have been the
places where children first learned about the world, where neighbors met, the social centers of towns and cities, the rallying points for revolts, the scenes of repression... The street has always been the scene of this conflict, between living and access, between resident and traveler, between
street life and the threat of death.”
– Donald Appleyard
“The balance is lost. Streets are now traffic corridors, literally cutting swathes through local communities. Official attention is concentrated on passing traffic, not local lives. Streets have become dirty and dangerous. Communities everywhere are affected, but more seriously in towns and cities and in low-income areas.”
Living Streets manifesto at
http://www.livingstreets.org.uk/manifesto.htm
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Streets used to be about... Home Exchange Learning Localness and distinctness Democracy Diversity and spontaneity Social levelling, variance and mixing
They were “rooms” to spend time in not “corridors” for movement
Over time changes in philosophy 1930s: Super segregation proposed
1950s-1970s: Segregation but hierarchical
1980/90s: Traffic calming
Early 2000s: Home Zones
Mid 2000s: Naked streets
Late 2000s: Shared Space
Late 2000s: DIY Streets
Future: David Engwicht?
Quality Streets?
30Nudge: changing infrastructure to
encourage behaviour change
An example of NUDGE
32Nudge: changing infrastructure to
encourage behaviour change
http://www.youtube.com/watch?v=2lXh2n0aPyw
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Nudge: On the streets
http://www.youtube.com/watch?v=iynzHWwJXaA
Quality of the urban environment
• What do we mean by each of these?
• Do they influence travel behaviour and modal choice?
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Character – streets should have character and reflect local identify, history and culture. Utilising local art and architecture can help enhance distinct and unique character and identity.
Continuity and enclosure - where public and private spaces are easily distinguished.
A quality public realm – good quality materials, easily maintained and replaced.
Ease of movement - should be enhanced for all users, along with permission to stop and dwell through benches and places to lean and creating focal points to commune at including fountains, works of art, sculptures, memorials or trees, gardens and other greenery.
Legibility – area should be designed in a way that is easy to understand and interpret, not just with signage but with other visual and tactile cues as well to help determine legitimacy in activity and determine use.
Adaptability –The place should be built to adapt to changes in the needs of users, policy and legislation over time.
Diversity and choice – Allowing area to be used by a large variety of individuals and uses, with minimum exclusion.
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37Improving the urban environment
1. Lack of nuisance Anti-social behaviour: decreasing levels of nuisance and addressing perceptions of nuisance,
e.g. where groups of young people are perceived as threatening, can make a difference. Vandalism: open spaces should be free from graffiti as this is a deterrent to the pursuit of
outdoor activities. Litter and rubbish: the condition of the environment in terms of maintenance was a main
concern for participants, suggesting that poor maintenance can decrease use of open spaces.
2. Quality paths Barrier-free paths: our findings suggest that walking is the prevalent form of transport for older
people, so it is crucial that paths leading to/from open spaces and key destinations be wide, smooth and free from obstacles.
3. Good facilities Furnished open spaces: the presence of seats, toilets, cafes and shelters were predictors of the
time participants spend outdoors and can significantly increase the incentive for undertaking outdoor activities.
4. Neighbourhood aesthetics Water features: attractive features in nearby outdoor spaces, such as a fountain or a lakeside,
may entice older people to use them more frequently. Quality of trees and plants: these elements are an important part of pleasant outdoor space
and were associated with significantly more time spent outdoors by participants, as well as being conducive to recreational walking.
Alves, S., Aspinall, P., Ward Thompson, C., Sugiyama, T., Brice, R. and Vickers, A. 2008. Preferences of Older People for Environmental Attributes of Local Parks: The Use of Choice-Based Conjoint Analysis. Facilities 26 (11/ 12), 433-453.
Sugiyama, T., Ward Thompson, C. and Alves, S. 2008. Associations between neighborhood open space attributes and quality of life for older people in Britain. Environment and Behavior, first published on March 20, 2008 as doi:10.1177/0013916507311688
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Make a more pleasant walking environment
Quality environment– Local materials =
sense of place– Local art, attention to
detail– Involvement of locals
= ownership by locals– Quality street
furniture
Good upkeep
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Make a more pleasant walking environment
Emphasise personal safety– Tress not shrubs– CCTV?
Increase permission to dwell– Benches– Public toilets– Fountains– Artwork– Squares/places/shops
spill onto pavement
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Make a more pleasant walking environment
Desire lines and connections– Reduce segregation– Formal crossings on
informal lines
Provide information– Out and about– Before hand
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Improving buses for older people
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Importance of buses for older
people
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Bus use and health
9.7million older and disabled concessionary travel passes were in use in England in 2013/4 (8.8 million or 91% of these are for older people).
Just over 1billion concessionary passenger journeys on buses in England in 2013/4.
Free bus use is a social leveller – more likley to be used by those on lower income (82% use for those on £15k less/year) Scott and Humphrey (2012)
Free travel equates to more bus use for older people (see Mackett, 2013a for review).
The journeys made are not just more numerous but also often longer in duration and distance (Andrews, 2011 ; Passenger Focus, 2009).
Free bus pass improves quality of life (Andrews , 2011; Rye and Myuka, 2009)
Improves physical health (walking either end, get out and about more) – Webb et al., 2013 cite bus use as a protective factor against obesity.
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Free bus pass worth A recent report by Greener Travel (2014) in conjunction with KPMG LLP used Department
for Transport guidance on economic appraisal and found for every £1 spent on the free bus pass for older people, £2.87 is returned to the economy. They broke the benefits into:-
Impacts for concessionary bus passengers– greater freedom to access services and activities– service frequency enhancements arising from the additional capacity required to carry
increased – the added convenience of smart and integrated ticketing.
Impacts for other bus users and other road users– Faster boarding times, with older people not having to pay– Keeps services going that would otherwise cease, extending value to paying customers too– Reduction in cars driven (and associated reduction in congestion, pollution and collisions)
Wider economic benefits– formal and informal voluntary work can be continued– social care and child care activities. The formula uses Royal Voluntary Service estimates that
people participating in voluntary work, social care and child care is £10 billion, £34 billion and £3 billion respectively (RVS, 2011)
Health and wellbeing benefits– Increased physical activity – Social inclusion, mental health and wellbeing benefits are noted as important but not
included in the final figure due to difficulties in quantification.
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Barriers to useFormal information
Alternative transport provided locally
Timetable of buses
Location of bus stops
Walking area
Real time information
Informal information
Does the bus leave when it says it does?
Ease of carrying shopping/luggage on a bus?
Ease of getting a seat on a bus?
State of the pavements for walking?
Provision of benches, formalised crossing areas, toilets etc.
Feeling of safety using transport/walking?
Attitude of bus driver
Ten most frequent barriers for respondents aged over 70 years, with the proportion of that age-group who reported each as a ‘problem’ (after Gilhooly, et al. 2002)
Information barriers to bus use for over 65s’ (after Musselwhite and Haddad, 2007)
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Improving bus use Broome et al (2013) looked at how to improve services and overcome barriers for older
people using buses in Queensland, Australia, using Brisbane as a control. Seven priorities were implemented:-
1. Accessibility, for example low floor buses to make boarding and alighting easier
2. Age friendly training for bus drivers (see also Broome 2010). This is also being rolled out across all 24,500 bus drivers in London by 2016 (see TfL, 2013)
3. Frequent buses and a call for evening and weekend services in particular.
4. Bus stops close to homes and destinations. Broome et al (2013) suggest a system should aim to stop within 200m of residences and destinations. Bus stops need to be of good quality too; they should provide shelter and aid boarding and alighting.
5. Accessible pedestrian infrastructure is important, footpaths and pedestrian crossing are part of the journey too.
6. Providing training and information for older people about how to use buses. However, bus buddy scheme has low uptake and knowledge and satisfaction declined. Alternative approaches are suggested such as more generic training of alternative modes associated with a programme of giving-up driving as suggested by Liddle et al. (2006) and Musselwhite (2010).
7. Bus systems need to provide access to destinations of interest to older people themselves and Broome et al. (2013) propose that older people should be more involved in design of routes
Cars aim at secondary and tertiary Mobility Needs
Is there a change?
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http://www.youtube.com/watch?v=snKbU5r0pBo&feature=plcp
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Conclusions
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Conclusions 1 Relatively safe as drivers
– Self regulation is crucial– How to encourage this?
Walking– Do not cater for older people’s needs and issues
very well– Need to improve and make areas more desirable
Bus– Free bus travel equates with health and wellbeing– Has high return on investment– But future bus cuts??
ReferencesInteresting further reading
Clarke, D. D., Ward, P., Truman, W., & Bartle, C. (2009) Collisions involving older drivers: An in-depth study. London, Department for Transport
Mackett, R. (2013a). The impact of concessionary bus travel on the wellbeing of older and disabled people. Paper presented at the Transportation Research Board 92nd Annual Meeting, Washington DC, 13-17 January. Transportation Research Record, 2352, pages 114-119.
Musselwhite, C. and Haddad, H. (2010). Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults. 11(1), 25-37
Musselwhite, C. (2011) Successfully giving up driving for older people. Discussion Paper. International Longevity Centre – UK
Sinnett, D., Williams, K., Chatterjee, K. and Cavill, N. (2011) Making the case for investment in the walking environment: A review of the evidence. Technical Report. Living Streets, London. Found via http://eprints.uwe.ac.uk/15502/
Siren, A. and Haustein, S. (in press) Driving licences and medical screening in old age. Review of literature and European licensing policies. Journal of Transport & Health.
Space between buildings film:- https://archive.org/details/SmallUrbanSpaces
Vanderbilt, T. (2008). Traffic. London: Penguin7
Webb, E., Netuveli, G., & Millett, C. (2012). Free bus passes, use of public transport and obesity among older people in England. Journal of Epidemiology and Community Health, 66(2), 176-180.
