This week’s blog comes from Philip Corran, a researcher at the Tavistock Institute of Human Relations. Philip recently completed a PhD focusing on the everyday travel of older disabled people in London, focusing on how they overcome the obstacles they face and the impact these challenges have on their health and wellbeing.
Everyday travel is an essential for leading a healthy and fulfilling life. We can see its importance in relation to both physical health and broader wellbeing. The exercise we get from walking and cycling, even if just to and from the nearest bus stop, is important; the recommended 150 minutes physical activity per week can be achieved by a ten-minute walk to and from the bus stop and a ten-minute round trip to buy lunch, five times a week.
Remaining socially included is another important determinant of health. Accessing services, social connections, visiting shops, and being able to volunteer; all these things are made possible through daily travel. Those who find travel more difficult are therefore at greater risk of social exclusion. Although I want to be careful about perpetuating stereotypes of older people as lonely and vulnerable, we should not overlook the impact that being less able to travel can have on their ability to socialise; even short shopping trips involve interacting with other people, and reaching friends and family often requires travelling.
More broadly, we can look at the ways everyday travel allows older people to achieve a higher quality of life. Travelling helps them to maintain their sense of independence and self-worth, access parks and other green spaces, and maintain a sense of ownership in their local area. If we want senior citizens to be healthy, live life to the full, and be included in wider society, they need to be able to travel.
On any given day, 16% of people in London do not leave the house. However, when we look at 70-79-year olds, this figure rises to 26%. For Londoners over the age of 80, 44% of them will not leave the house on a given day. There is nothing inherently wrong with staying at home all day; spending time at home can provide the opportunity to spend time with family, relax or engage in other leisure pursuits. However, we know that older people, especially those experiencing chronic illness and/or disability, face many challenges travelling in London, despite the city’s extensive transport network. These challenges are diverse and vary greatly; some are unavoidable consequences of conditions like arthritis or lung disease. Many are consequences of the disregard for older and disabled people built into London’s transport system and wider environment. Although we cannot quantify the effects that these difficulties have, they do seem to play a role not only in older people’s lower propensity to leave the house, but also in their experience of travel and ability to attain wellbeing.
We generally talk about the challenges older people face when travelling as ‘barriers’. Some of these barriers may be insurmountable, others may just make travel more stressful, time consuming and arduous. To illustrate this, it seems best to illustrate using words chosen by older people themselves:
“I still enjoy getting out the house and going to these places but it’s that anxiety about what I’m gonna be facing to get there… it does put you off, let’s put it that way.”
– Andy, 64, carer to her husband John, 82, who has Parkinson’s disease.
Andy demonstrates some of the limitations and anxiety induced by London’s transport system. For Andy, whether she and her husband would have space in the wheelchair bay on the bus often felt like a lottery, and the lack of step-free access at their nearest train station made accessing central London near impossible. Others involved in my research had to push through chronic pain to climb staircases, lean against walls to rest during longer walks, plan their trips with ‘military precision’ and carry contingency money to take cabs when the exertion involved in taking public transport became too much.
Despite its disproportionate size and subsidies from central government, London’s transport infrastructure and built environment can often feel hostile for older people, especially those experiencing disability or chronic illness. Older people need better information on the options and help available to them, transport staff need better training on how to accommodate an assist older people, and the wider public must better understand and accommodate the needs of older people.
Progress is being made: more stations are becoming step-free, TfL’s ‘healthy streets’ strategy is improving the environment older pedestrians must navigate when travelling, and organisations like Alzheimer’s UK have seen success in campaigning for better training for staff in the transport system. However, the pace of change remains slow. As long as this is the case, older disabled Londoners will face formidable obstacles in achieving healthy and fulfilling later lives.