'Getting out and about' A Community Matters seminar from ILC-UK and Age UK

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The slides from the first in a series of three seminars from ILC-UK and Age UK on Community Matters - are our communities ready for ageing?

Full details here: http://www.ilcuk.org.uk/index.php/events/community_matters_are_our_communities_ready_for_ageing_getting_out_and_abou

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  • However, our current project is focusing on the positive – what is it about getting outdoors that makes things enjoyable and meaningful, reinforcing the benefits and reducing anxiety?In particular, what might be the environments that are ‘restorative’, that help people cope better with busy streets, for example, when they do have to encounter them? Alertness vs relaxation.
  • The pedestrian experience is vitally important to older people, who are most often on foot when out and about. For the many who find it difficult to get around, it is often due to the poor design, provision, installation or upkeep of neighbourhood features, especially footways. Lesser-quality environments are often considered by older people to pose an increased falls risk, especially by those with vision, mobility or other impairments. They can heighten fears about crime, nuisance and traffic and make going outdoors less enticing; reinforcing feelings of loneliness or entrenching the challenges of socio-economic deprivation. Inconsistency, e.g. between types of road crossing and tactile paving, can make older people uncertain about features that are designed to be enabling.If older people live in an environment that makes it easy and enjoyable for them to go outdoors (i.e. a supportive environment), they are more likely to spend a longer time outdoors, be more physically active and more satisfied with life. They are twice as likely to achieve the recommended levels of healthy walking.Living within 10 minutes’ walk of a local park, and having good quality paths on the way to the park, are associated with up to twice the odds of undertaking 2.5 hours of walking per week. Living within 10 minute’s walk of the local park is associated with over twice the odds of being satisfied with life, and pleasantness of this local open space, as well as safety, are also associated with nearly twice the odds of satisfaction with life.People living in their own home are almost 3 times (1/0.34) more likely than people living in shelter/care home to attain 5 hour or more of total outdoor time/week.Recent research into the Lothian Birth Cohort found that people aged over 70 who took regular exercise showed less brain shrinkage over a three-year period than those who did little exercise. The Edinburgh team used MRI scans to measure the volume of brain tissue and the volume and health of the brain’s white matter in almost 700 people. The research supports the view that physical exercise has a more beneficial effect than “mental exercise.”In 21stC. developments, residential outdoor space (ROS) tends to be less green than it was pre-2000. The levels of such space in the rising number of homes built for older people is below average. Older people’s wellbeing is enhanced by having an accessible outdoor space or a green view, and the more types of residential open space, whether owned or shared, the greater older people’s satisfaction is likely to be. Front gardens, in particular, are valued as a place for social interaction. Some of the positive effects of residential open space on wellbeing actually appear to strengthen as people age.
  • What level of environmental quality in the residential street or local neighbourhood is sufficient to support healthy activity levels or quality of life for older people?What kinds of environmental improvements can be demonstrated to increase levels of outdoor activity in older people? Does outdoor activity per se reduce social isolation as well as enhance physical and mental health?Removing barriers is necessary but not sufficient to increase mobility. We need to understand the positive qualities that encourage people to go out, remain active, and give them pleasure into very old age. How can we ensure people have access to emotionally positive and meaningful places throughout their lives and especially into very old age?What is a minimum acceptable standard of residential open space provision to ensure opportunities for wellbeing are maximized into very old age? Do views of green space or nature matter as much (or more) than access to such spaces outdoors?What levels and types of public lighting might make a difference to older people’s outdoor access at night? Is this a sensible strategy to pursue or a waste of investment, given many older people’s reluctance to go out at night in any case?One challenge in current times is that so much decision-making is now devolved down to authorities, rather than legislated for at national level. This is not such a challenge when funding is adequate, but the current squeeze on local government funding means that authorities struggle to know how to carry out just their statutory duties. Areas that are non-mandatory end up at the bottom of the pile in terms of attention or investment.
  • 1 - Rationalise the planning system. We have national planning guidance, National planning policies, Strategic plans, Regional Spatial strategies and Local plans. In all of these different areas non mandatory features such as open space/green space can slip through the cracks and get lost. e.g. Housing can involve By Design – Urban Design in the Planning System: Towards Better Practice, DETR, 2000.Safer Places – the Planning System and Crime Prevention, ODPM, 2004.Planning and Access for Disabled People: A Good Practice Guide, ODPM, 2005.Better Places to Live By Design: A Companion Guide to PPG3, DTLR, 2001.Secured by Design, see www.securedbydesign.comBuilding for Life Standards, see www.buildingforlife.orgDesign Quality Indicator toolkit, see www.dqi.org.uk/DQIForthcoming Manual for Streets Guidance (DfT/Communities and Local Government).See Preparing Design Codes – A Practice Manual, Communities and Local Government 2006. 2 – Recognising the physical and mental health benefits of access to green space place a mandatory requirement for residents in care homes to have access to gardens. 3 – Recognising the health benefits of access to green space place spending on green space under the umbrella of health and so ringfence it. 4 - Place a mandatory requirement on private developers to provide suitable green space in housing developments on-site.  England - Planning policy states that all private developments over 10 houses must incorporate open space. However, in exceptional circumstances, which are not stipulated, the space provided may be an off-site piece of land. In addition there is no stipulation in the guidance that the open space be suitable to the development. There is nothing to stop the open space being merely a grassed area tacked onto the development as an afterthought.http://www.gov.uk/government/uploads/system/uploads/attachment_data/file/6077/2116950.pdf Scotland - Designing Streets: A Policy Statement for Scotland, changed the emphasis of guidance on street design towards place-making. However, while planning applications for residential developments may be expected to confirm with these principles on open space provision within the design of new residential development there is no legal requirement to do so. Some developments may be passed if developers contribute to an off-site piece of open space.http://www.scotland.gov.uk/Resource/Doc/307126/0096540.pdf 5 – Create a set of national standards for road crossings incorporating types, siting, and maintenance with a mandatory requirement on local authorities to adhere to such standards.
  • 'Getting out and about' A Community Matters seminar from ILC-UK and Age UK

    1. 1. Community Matters – are our communities ready for ageing? Seminar 1: ‘Getting out and about’ Tuesday 11th March This event is kindly supported by Age UK #communitymatters
    2. 2. Malcolm Dean This event is kindly supported by Age UK #communitymatters
    3. 3. Phil Rossall Research Manager Age UK This event is kindly supported by Age UK #communitymatters
    4. 4. David Sinclair Assistant Director, Policy and Communications ILC-UK This event is kindly supported by Age UK #communitymatters
    5. 5. Dr Charles Musselwhite Associate Professor University of Swansea This event is kindly supported by Age UK #communitymatters
    6. 6. Community Matters: are our communities ready for ageing: Getting out and about Setting the scene – where are we now and where do we want to be Dr Charles Musselwhite Associate Professor/Reader in Gerontology c.b.a.musselwhite@swansea.ac.uk www.drcharliemuss.com
    7. 7. A reduction in mobility can result in an increase in isolation, loneliness and depression and an overall a poorer quality of life. (Fonda, et al., 2001; Ling and Mannion, 1995; Schlag, et al., 1996)
    8. 8. More miles driven per person Source: DfT (2002, 2006, 2010) Older people are more healthy and active as a cohort than ever before and as such are also more mobile (Tomassini, 2004). Increasing hypermobile society, where services, shops, work and families are increasingly dispersed Increasingly reliant on the car Growth in % licence holders over 70 years 0 500 1000 1500 2000 2500 3000 3500 4000 4500 1995/97 1998/00 2002 2005 2010 2011 2012 Milesdriven/person/yearGB Miles driven GB 60-69 70+ All ages +77% +37% -8% - 10 20 30 40 50 60 70 80 90 % of GB licence holders over 70 female male
    9. 9. W-H • Especially by car Source: Musselwhite, C. and Haddad, H. (2010). Mobility, accessibility and quality of later life. Quality in Ageing and Older Adults. 11(1), 25-37. PRIMARY MOBILITY NEEDS Practical/utilitarian Needs e.g. get from A to B as safely, reliably, cheaply and comfortably as possible. SECONDARY MOBILITY NEEDS Social/affective Needs e.g. The need for independence, control, to be seen as normal. Linked to status, roles, identity, self-esteem. Impression management On giving-up driving this level of needs is adversely affected Isolation, no longer part of society, no longer feel normal TERTIARY MOBILITY NEEDS Aesthetic Needs e.g. The need for the journey itself for relaxation, visit nature, use and test cognitive skills A reduction in mobility can result in an increase in isolation, loneliness and depression and an overall a poorer quality of life. On giving-up driving this level of needs is adversely affected Not so easy to ask for discretionary travel On giving-up driving – this level of need is usually met  friends  accessible transport  public transport  teleshopping? “Well Dorothy and David from number 3 take me shopping every week, we all go, we have a bit of a time of it you know, it’s a kind of outing. I never expected that. ” (Female, gave-up driving at 80) “It’s hard to explain I suppose. You just don’t seem like you belong. I suppose yes there are feelings that you might be ready for the scrapheap now. The first step to it, you know” (Male, given-up driving at 76) “You can’t ask other people to take you out for “a drive”. They’d think you’d lost their senses. Anyway they have got better things to be doing with their time, then ferrying me about just for the sake, like” (female, gave-up driving at 80)
    10. 10. Traditional Categorisation of Trip Purposes 10/ “Essential” Tourist“Discretionary” Travel for Utility • Time wasted: to be minimised • Distance to be overcome • Destination-focussed • Routine • Often Essential, Productive Travel for Tourism • Novel • Enriching • Less destination focussed Economic Priority Economic Priority
    11. 11. Prolong safe driving?
    12. 12. To consider... • Therefore in general terms, the more complex road environments are, the higher the accident involvement for older drivers. • „Self-explaining‟ roads which include perceptual cues are needed e.g. • “This is a „quick win‟ area, in which many of the benefits are likely to extend beyond older drivers to the rest of the driving population”. (Box et al., 2011) • To help older people stay driving later on in their life, should we design an infrastructure to help them be safe? – Would it be a safer environment for everyone? 12 Change the infrastructure Self-explaining roads
    13. 13. Dashboard sign display (with user prioritisation) Head-up sign display (with user prioritisation) Head-up display of current vehicle speed Audible speed cue (driving speed) Audible warning when reach actual speed limit Intelligent Speed Adaptation GLARE AND LUMINANCE Night vision enhancement Head-up display Dashboard display EXTERNAL DISTRACTIONS MAINTAINING A CONSTANT SPEED Change the vehicle Increase the automation? Musselwhite, C. and Haddad, H. (2008). Prolonging safe driving through technology. Final Report. UWE
    14. 14. Change the law: Restrict driving Re-take driving test Stricter medical test No to extra tests Other than for prompting Self-regulation? Works well, but the future with working later? More car centric society? 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).
    15. 15. Change the driver Education: Improves self-awareness Training, education Feedback from others, the environment, cars But how aware are you in wider social context? Who would want to be educated? Who would bear the cost? Who would attend? Age discrimination? How to improve self-awareness Cognitive tests On-road tests Classroom/group work Role of ADIs Physiological test? Cognitive tests On-road tests Do the courses work? Evidence? How would the evidence look? Course Must allow self-reflection Must allow chance for fail Must encourage strategies to adopt to help self- regulation Must provide help with alternatives Involve Forum of Mobility Centres Look for champions and leaders AA Drive Tech Wessex DriveAbility Musselwhite, C.B.A. (2010). The role of education and training in helping older people to travel after the cessation of driving International Journal of Education and Ageing 1(2) , 197-212 Musselwhite, C. (2011) Successfully giving up driving for older people. Discussion Paper. International Longevity Centre - UK.
    16. 16. Leaving the vehicle behind
    17. 17. Multimodal Re-engage in immediate locale Literal Potential Virtual Imaginative Successful at giving-up driving Plan in advance Trial and error Support of family and friends “I’ve re-discovered my local area. Which is great. I forgot what the village has to offer. In fact I think it is better than a few years ago. But not using the car has forced me to use more local things.” (female, aged 75) “The bus out is a real bit of fun. I go on it with friends... and we have a day out” (female, aged 70) Musselwhite, C.B.A. and Shergold, I. (2013). Examining the process of driving cessation in later life. European Journal of Ageing. 10(2), 89-100
    18. 18. • Bus use • Unprecedented cuts in services • Growth of community transport Issues:- • Must communicate the benefits of free bus pass – Wider economic and social benefits to individuals and society – Need to map return on investment • Quality of service • For aesthetic purposes – just getting out and about Formal 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 Musselwhite, C.B.A. (2010). The role of education and training in helping older people to travel after the cessation of driving International Journal of Education and Ageing 1(2) , 197- 212
    19. 19. It is estimated there are around 300,000 mobility-scooter users in the UK (DfT, 2010c). Very positively received by users as they help maintain freedom and independence (e.g Barham et al., 2006; DfT, 2010c; Steyn and Chan, 2008). Issues:- Who uses them? Insurance and safety? But do they replace walking and effect health? Thoreux (2011) perform worse than non-users. The role of mobility scooters
    20. 20. DfT Minimum crossing speed 1.22m/s (88% not walking fast enough!) Walking TERTIARY TRAVEL NEEDS Aesthetic Needs Pleasantness/desirability of neighbourhood open spaces (trees, plants, waterscapes) SECONDARY TRAVEL NEEDS Social Needs A place to make a statement and interact e.g. suitable spaces to socialize. Inter-generational community important PRIMARY TRAVEL NEEDS Practical Needs Large, open, un-crowded, low level of noise. Lack of nuisance. Well maintained paths for movement. Facilities and amenities. Only 11% walk as fast or faster than DfT recommendations for pedestrian crossing time Only 6% of females Faster if higher socio-economic background, healthy and confident Agrees with previous research (Asher et al., 2012, Newton and Omerod, 2007). fear of not being quick enough to cross the road is known to restrict people leaving the home or limit their accessibility when out and about (IDGO 2013; Lord et al., 2010; Zijlstra, 2007). Make streets attractive Musselwhite, C.B.A. (2014). Environment-person interactions enabling walking in later life Proceedings of the 46th Annual UTSG Conference, Transport Operations Research Group, Newcastle University, 6th January
    21. 21. Conclusion
    22. 22. • Transport is more than just A to B • Provision beyond the car must reflect diverse patterns of travel and individual need. • How to help break the giving-up driving = poorer health and wellbeing correlation • Integration: within travel training, within provision and services. • Multimodality from a young age. • Increasing need to prove mobility is important (and the wider economic and social benefits). • Future: – Novel solutions. ITN America. – Re-inventing existing solutions: Taxis/cycling – Milton Keynes Pods – Nature of working later? Health and fitness of society? Falling out of love with the car? Will we even have cars? – Role of Virtual mobility?
    23. 23. Professor Catharine Ward-Thompson Director OPENspace Research Centre University of Edinburgh This event is kindly supported by Age UK #communitymatters
    24. 24. Getting Out and About: where are we now and where do we want to be? Catharine Ward Thompson Professor of Landscape Architecture Director of OPENspace Research Centre The research centre for inclusive access to outdoor environments
    25. 25. Inclusive Design for Getting Outdoors - Creating Age-friendly Outdoor Environments
    26. 26. Mobility, Mood and Place (MMP) explores how places can be designed collaboratively to make mobility easy, enjoyable and meaningful for older people.
    27. 27. Evidence: What we know
    28. 28. Evidence: What we know • The pedestrian experience is vitally important to older people, who are most often on foot when out and about. • Poor quality environments are seen as increasing falls risks and can exacerbate the challenges of socio-economic deprivation and social isolation • A supportive environment – one that makes it easy and enjoyable to get outdoors – is associated with a range of physical, mental and social well being outcomes • Living within 10 minutes’ walk of a pleasant local park, and having easy and enjoyable routes to get there, makes a big difference to likely levels of walking and satisfaction with life • People living in care homes are very much less likely to get outdoors than those living in their own homes • Physical exercise has a more beneficial effect on older people in delaying brain shrinkage than ‘mental exercise’ • Older people’s wellbeing is enhanced by having an accessible outdoor space and a green view.
    29. 29. Gaps in research and policy
    30. 30. Gaps in research and policy • What level of environmental quality in the residential street, park or local neighbourhood is sufficient – good enough to support health and quality of life for older people? • Can environmental improvements alone be demonstrated to increase levels of outdoor activity in older people? If so, what kind? • Does outdoor activity per se reduce social isolation as well as enhance physical and mental health? • What are the positive qualities/assets that encourage people to go out, remain active, and give them pleasure into very old age? • What levels and types of public lighting might make a difference to older people’s outdoor access at night? Is this a sensible strategy to pursue or a waste of investment? • What is a minimum acceptable standard of residential open space provision to ensure opportunities for wellbeing are maximized into very old age?
    31. 31. Image courtesy of Sustrans Five things that might fix some of these issues
    32. 32. Image courtesy of Sustrans Five things that might fix some of these issues 1 Rationalise the planning system so that non-mandatory features such as open space/green space don’t ‘slip through the cracks’ and get lost. An appropriate minimum standard of access to green space might be based on the Accessible Natural Greenspace Standard (ANGSt) 2 Recognising the physical and mental health benefits of access to green space, place a mandatory requirement for residents in care homes to have access to gardens and assistance to enjoy them. 3 Recognising the health benefits of access to green space, place spending on green space under the umbrella of health and so ringfence it. It requires a commitment to recurrent spend. 4 Place a mandatory requirement on private developers to provide suitable green space in housing developments on-site. 5 Create a set of national standards for road crossings incorporating types, siting, and maintenance with a mandatory requirement on local authorities to adhere to such standards.
    33. 33. Sophie Handler Research and Planning Officer Age-Friendly Manchester Chair RIBA working group on Ageing This event is kindly supported by Age UK #communitymatters
    34. 34. Getting Out and About in older age What do we know? 1. the ‘amplification of impact’ the disproportionately disabling impact of obstructive, urban environments on older people 2. ‘alienation’ from urban surroundings > cities structured to meet needs of a working age demographic > the vital but often neglected role of older people in planning and design processes > the less visible impact of urban environments on people’s identity, sense of self and belonging in older age 3. the inherent value of public spaces the value of spaces that can be used, shared and appropriated (even in older age)
    35. 35. What are the gaps in research and policy that we need to fill? 1. Scale and sustainability developing sustainable policies that connect city-wide programmes to the fine grain of community-led initiatives – in ways that support older people in getting out and about over the long-term 2. Developing policies that think beyond the physical what kinds of programmes, policies and initiatives might be developed together with older people to support and encourage older people to feel more confident in getting out and about? 3. Alternative forms of urban design practice what can we learn from creative, relational forms of design practice in encouraging older people to ‘lay claim’ to their urban surroundings?
    36. 36. If you were a minister, what are the five things you would do fix some of these issues? 1. Encourage original urban research work with funding councils to support innovative and creative inter-disciplinary practice-led research and collaborations 2. Champion best practice promote and disseminate best practice on creating age-inclusive spaces – to inform and animate public debate 3. Support Local Authorities support programmes and initiatives that share learning between cities across the UK (develop a learning infrastructure and resource for local authorities across the UK) 4. Engage Professional Bodies work with professional bodies to build an ageing lense into professional standards and practice 5. Promote integrated Age-Friendly Cities approach sponsor programme development of Age-Friendly Cities and Communities (based on the integrated WHO approach)
    37. 37. Dr C.G.B. "Kit“ Mitchell Co-chair Transportation Research Board's Committee on Accessible Transportation and Mobility This event is kindly supported by Age UK #communitymatters
    38. 38. Mobility – what we know • As we age, we make fewer journeys; • • The reduction is almost wholly due to fewer car driver journeys; • Older people are more than average likely to live in low density areas; • • By age 80, about 10% of male and 20% of female drivers will have surrendered their licence.
    39. 39. Trips per year for men and women in Great Britain 2011-12 Men WomenCar driver Car passenger Other Walk Bus - 200 400 600 800 1,000 1,200 40- 49 50- 54 55- 59 60- 64 65- 69 70- 74 75- 79 80- 84 85+ Journeysperyear. Age group 0 200 400 600 800 1,000 1,200 40-4950-5455-5960-6465-6970-7475-7980-8485+
    40. 40. 0 5 10 15 20 25 30 35 40 10 100 1,000 10,000 Percentageofretirementage. Population density people per sq.km. PERCENTAGE POPULATION RETIRED GREAT BRITAIN 2008
    41. 41. 0 5 10 15 20 25 30 35 40 50 55 60 65 70 75 80 85 90 Reductioninlicenceholdingfrom. peakforcohort. Age PERCENTAGE OF CAR DRIVERS WHOSE LICENCE HAS LAPSED Men Women
    42. 42. Mobility – what we do not know • What we can do to help older women continue to drive safely and without stress, at least locally; • • How to encourage older people to settle in areas where they will not be wholly car dependent;
    43. 43. Mobility – suggestions for Minister • Require drivers over 70 to submit an optician’s certificate with licence renewal; • • Encourage and support local authority schemes for older driver voluntary checks; • Study the US guidelines for highway design for older drivers, to introduce appropriate sections here.
    44. 44. 0 0 0 1 1 1 1 1 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80+ WOMEN
    45. 45. 0 100 200 300 400 500 600 700 800 900 1000 21- 29 30- 39 40- 49 50- 54 55- 59 60- 64 65- 69 70- 74 75- 79 80- 84 85+ Cardriverjourneysperdriver. peryear. Age group CAR DRIVER JOURNEYS PER LICENSED DRIVER 2011-12 Men Women
    46. 46. 0 2 4 6 8 10 12 21- 29 30- 39 40- 49 50- 54 55- 59 60- 64 65- 69 70- 74 75- 79 80- 84 85+ Lengthofcardriverjourneys,miles. Age group LENGTH OFCAR DRIVER JOURNEYS 2011-12 Men Women
    47. 47. Community Matters – are our communities ready for ageing? Seminar 1: ‘Getting out and about’ Tuesday 11th March This event is kindly supported by Age UK #communitymatters

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