1
|
Baumgart S, Bolte G. [Promoting active mobility in old age through urban design]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:910-920. [PMID: 38987453 PMCID: PMC11281947 DOI: 10.1007/s00103-024-03922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/20/2024] [Indexed: 07/12/2024]
Abstract
In an ageing society, maintaining independent mobility into old age is an important objective. Mental and physical wellbeing depends not only on individual health status, but also to a large extent on the spatial conditions. Local politics and municipal administrations can influence this, especially in urban planning. This discussion article brings together perspectives from public health and urban planning on urban development and mobility against the background of health equity.The results of the AFOOT (Securing urban mobility of an ageing population) cross-sectional study on socio-spatial conditions in small- and medium-sized towns in northwestern Germany and walking and cycling by older people show the importance of residential environmental factors such as proximity to everyday destinations, walking and cycling infrastructure, and street connectivity. Preferences for the design of an age-friendly living environment and the quality of public spaces exist in terms of urban design quality, quality of stay, and safety in public spaces.In order to improve spatial conditions, the situation needs to be recorded using defined indicators and monitoring, and the perspectives of older people need to be integrated. Strategies and measures to promote active mobility in old age are aimed at the multifunctional design of public spaces, the prioritization of active mobility on everyday trips, and ensuring the accessibility of everyday destinations through urban development. Cross-sectoral cooperation between urban planning, transport planning, and public health is essential to promote the active mobility and health of older people.
Collapse
Affiliation(s)
- Sabine Baumgart
- Institut für Public Health und Pflegeforschung, Abteilung Sozialepidemiologie, Universität Bremen, Grazer Str. 4, 28359, Bremen, Deutschland
- BPW Stadtplanung, Bremen, Deutschland
| | - Gabriele Bolte
- Institut für Public Health und Pflegeforschung, Abteilung Sozialepidemiologie, Universität Bremen, Grazer Str. 4, 28359, Bremen, Deutschland.
| |
Collapse
|
2
|
Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes. DATA SOURCES PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021. STUDY SECTION Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted. DATA EXTRACTION The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted. DATA SYNTHESIS Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors. CONCLUSIONS Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.
Collapse
Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| |
Collapse
|
3
|
Müller C, Domokos B, Amersbach T, Hausmayer EM, Roßmann C, Wallmann-Sperlich B, Bucksch J. Development and reliability testing of an audit toolbox for the assessment of the physical activity friendliness of urban and rural environments in Germany. Front Public Health 2023; 11:1153088. [PMID: 37637797 PMCID: PMC10449332 DOI: 10.3389/fpubh.2023.1153088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Background According to socio-ecological theories, physical activity behaviors are linked to the physical and social neighborhood environment. Reliable and contextually adapted instruments are needed to assess environmental characteristics related to physical activity. This work aims to develop an audit toolbox adapted to the German context, to urban and rural settings, for different population groups, and different types of physical activity; and to evaluate its inter-rater reliability. Methods We conducted a systematic literature search to collect existing audit tools and to identify the latest evidence of environmental factors influencing physical activity in general, as well as in German populations. The results guided the construction of a category system for the toolbox. Items were assigned to the categories based on their relevance to physical activity and to the German context as well as their comprehensibility. We piloted the toolbox in different urban and rural areas (100 street segments, 15 parks, and 21 playgrounds) and calculated inter-rater reliability by Cohen's Kappa. Results The audit toolbox comprises a basic streetscape audit with seven categories (land use and destinations, traffic safety, pedestrian infrastructure, cycling infrastructure, attractiveness, social environment, and subjective assessment), as well as supplementary tools for children and adolescents, seniors and people with impaired mobility, parks and public open spaces, playgrounds, and rural areas. 76 % of all included items had moderate, substantial, or almost perfect inter-rater reliability (κ > 0.4). Conclusions The audit toolbox is an innovative and reliable instrument for the assessment of the physical activity friendliness of urban and rural environments in Germany.
Collapse
Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Bruno Domokos
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Tanja Amersbach
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Eva-Maria Hausmayer
- Institute of Sport Science, University of Wurzburg, Wurzburg, Germany
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| | | | | | - Jens Bucksch
- Department of Prevention and Health Promotion, Faculty of Natural and Sociological Sciences, Heidelberg University of Education, Heidelberg, Germany
| |
Collapse
|
4
|
Maresova P, Krejcar O, Maskuriy R, Bakar NAA, Selamat A, Truhlarova Z, Horak J, Joukl M, Vítkova L. Challenges and opportunity in mobility among older adults - key determinant identification. BMC Geriatr 2023; 23:447. [PMID: 37474928 PMCID: PMC10360303 DOI: 10.1186/s12877-023-04106-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Attention is focused on the health and physical fitness of older adults due to their increasing age. Maintaining physical abilities, including safe walking and movement, significantly contributes to the perception of health in old age. One of the early signs of declining fitness in older adults is limited mobility. Approximately one third of 70-year-olds and most 80-year-olds report restrictions on mobility in their apartments and immediate surroundings. Restriction or loss of mobility is a complex multifactorial process, which makes older adults prone to falls, injuries, and hospitalizations and worsens their quality of life while increasing overall mortality. OBJECTIVE The objective of the study is to identify the factors that have had a significant impact on mobility in recent years and currently, and to identify gaps in our understanding of these factors. The study aims to highlight areas where further research is needed and where new and effective solutions are required. METHODS The PRISMA methodology was used to conduct a scoping review in the Scopus and Web of Science databases. Papers published from 2007 to 2021 were searched in November 2021. Of these, 52 papers were selected from the initial 788 outputs for the final analysis. RESULTS The final selected papers were analyzed, and the key determinants were found to be environmental, physical, cognitive, and psychosocial, which confirms the findings of previous studies. One new determinant is technological. New and effective solutions lie in understanding the interactions between different determinants of mobility, addressing environmental factors, and exploring opportunities in the context of emerging technologies, such as the integration of smart home technologies, design of accessible and age-friendly public spaces, development of policies and regulations, and exploration of innovative financing models to support the integration of assistive technologies into the lives of seniors. CONCLUSION For an effective and comprehensive solution to support senior mobility, the determinants cannot be solved separately. Physical, cognitive, psychosocial, and technological determinants can often be perceived as the cause/motivation for mobility. Further research on these determinants can help to arrive at solutions for environmental determinants, which, in turn, will help improve mobility. Future studies should investigate financial aspects, especially since many technological solutions are expensive and not commonly available, which limits their use.
Collapse
Affiliation(s)
- Petra Maresova
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Ondrej Krejcar
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic.
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia.
| | | | | | - Ali Selamat
- Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia
| | - Zuzana Truhlarova
- Faculty of Education, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Jiri Horak
- Faculty of Mining and Geology, VSB-Technical University of Ostrava, 17. Listopadu 2172/15, Ostrava-Poruba, 708 00, Czech Republic
| | - Miroslav Joukl
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| | - Lucie Vítkova
- Philosophical Faculty, University of Hradec Kralove, Rokitanskeho 62, Hradec Kralove, 500 03, Czech Republic
| |
Collapse
|
5
|
Vega Naranjo JM, Jiménez-Espada M, Martínez García FM, González-Escobar R, Cortés-Pérez JP. Intercity Mobility Assessment Facing the Demographic Challenge: A Survey-Based Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1163. [PMID: 36673918 PMCID: PMC9859263 DOI: 10.3390/ijerph20021163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The key factor in moving towards a more sustainable travel model is based on improving mobility, especially in rural areas that share territorial dynamics with urban areas and are connected by a daily flow of inhabitants. The purpose of this article is to carry out a diagnosis of the daily mobility patterns of the inhabitants of a number of rural municipalities, with the aim of promoting sustainability and mitigating the phenomenon of territorial depopulation in future local planning policies. The research methodology is based on the use of revealed preference surveys together with accessibility analysis using GIS tools, allowing for an in-depth knowledge of the mobility patterns of the municipalities in the area under analysis. In this respect, the reference parameters in terms of territorial accessibility are determined by applying the network analysis procedure to basic public services. The results reflect the existence of an unbalanced modal split with a preponderance of private vehicle use (regardless of the destination or the reason for the journey). In addition, a very weak inter-municipal connection dynamic is observed. There is a knowledge gap in the verification of the long-term suitability of sustainable measures in rural areas implemented after the development of mobility plans (in order to assess their effectiveness).
Collapse
Affiliation(s)
- Juan Miguel Vega Naranjo
- Department of Construction, Research Institute for Sustainable Territorial Development (INTERRA), School of Technology, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
| | - Montaña Jiménez-Espada
- Department of Construction, Research Institute for Sustainable Territorial Development (INTERRA), School of Technology, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
| | | | - Rafael González-Escobar
- Department of Construction, Research Institute for Sustainable Territorial Development (INTERRA), School of Technology, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
| | - Juan Pedro Cortés-Pérez
- Department of Construction, Research Institute for Sustainable Territorial Development (INTERRA), School of Technology, Universidad de Extremadura, Avda de la Universidad s/n, 10003 Cáceres, Spain
| |
Collapse
|
6
|
Choe EY, Du Y, Sun G. Decline in older adults' daily mobility during the COVID-19 pandemic: the role of individual and built environment factors. BMC Public Health 2022; 22:2317. [PMID: 36503494 PMCID: PMC9742036 DOI: 10.1186/s12889-022-14780-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Extensive research has shown that the COVID-19 pandemic dramatically impacted the daily mobility of older adults. However, very little attention has been paid to the role of individual and built environmental factors in decline in older adults' daily mobility during the pandemic. METHODS Based on a cohort survey of 741 older adults in Hong Kong, we conducted a one-way ANOVA to explore the differences in determinants (individual or environmental factors) of older adults' daily mobility between before and during the COVID-19 pandemic. Further, multilevel linear regression was performed to examine how individual characteristics and built environment factors are associated with changes in older adults' daily mobility during the pandemic. RESULTS Results show that the duration of active travel declined from 174.72 to 76.92 min per week, and that the public transport use frequency decreased from an average of 6.14 to 3.96 trips per week during the COVID-19 pandemic (before the rollout of vaccination programme). We also found residential density (p < 0.05) and the number of bus stop was negatively associated with the decline in their active travel (p < 0.01), while a higher destination mix was associated with more significant decrease in active travel (p < 0.01). A higher availability of recreational facilities in neighbourhoods was associated with a greater decrease in public transport use (p < 0.05). In addition, those who were older or having depressive symptoms, which are considered a vulnerable group, were negatively associated with decrease in their mobility (p < 0.001). CONCLUSIONS Maintaining mobility and social interactions are crucial for older adults' health during the COVID-19 pandemic. This study found that individual and environmental factors differentially affected older adults' active travel and public transport use during the pandemic. Our findings contribute to understanding the COVID-19 impact on daily mobility in older adults and support more effective active travel promotion policies in the post-pandemic future.
Collapse
Affiliation(s)
- Eun Yeong Choe
- grid.194645.b0000000121742757Urban Analytics and Interventions Research Lab, Department of Urban Planning and Design, The University of Hong Kong, Hong Kong SAR, China
| | - Yao Du
- grid.194645.b0000000121742757Urban Analytics and Interventions Research Lab, Department of Urban Planning and Design, The University of Hong Kong, Hong Kong SAR, China
| | - Guibo Sun
- grid.194645.b0000000121742757Urban Analytics and Interventions Research Lab, Department of Urban Planning and Design, The University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
7
|
Evaluating the Effects of Built Environment on Street Vitality at the City Level: An Empirical Research Based on Spatial Panel Durbin Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031664. [PMID: 35162687 PMCID: PMC8835322 DOI: 10.3390/ijerph19031664] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 02/01/2023]
Abstract
There is evidence that the built environment has an influence on street vitality. However, previous studies seldom assess the direct, indirect, and total effect of multiple environmental elements at the city level. In this study, the features of the street vitality on Xiamen Island are described based on the location-based service Big Data. Xiamen Island is the central urban area of Xiamen, one of the national central cities in China. With the help of multi-source data such as street view images, the condition of design that is difficult to effectively measure with traditional data can be better explored in detail on a macro scale. The built environment is measured through a 5D system at the city level, including Density, Diversity, Design, Destination accessibility, and Distance to transit. Spatial panel Durbin models are constructed to analyze the influence of the built environment on the street vitality on weekdays and weekends, and the direct, indirect, and total effects are evaluated. Results indicate that at the city level, the built environment plays a significant role in promoting street vitality. Functional density is not statistically significant. Most of the elements have spatial effects, except for several indicators in the condition of the design. Compared with the conclusions of previous studies, some indicators have different effects on different spatial scales. For instance, on the micro scale, greening can enhance the attractiveness of streets. However, on the macro scale, too much greening brings fewer functions along the street, which inhibits the street vitality. The condition of design has the greatest effect, followed by destination accessibility. The differences in the influences of weekdays and weekends are mainly caused by commuting behaviors. Most of the built environment elements have stronger effects on weekends, indicating that people interact with the environment more easily during this period.
Collapse
|
8
|
Brüchert T, Quentin P, Baumgart S, Bolte G. Barriers, Facilitating Factors, and Intersectoral Collaboration for Promoting Active Mobility for Healthy Aging-A Qualitative Study within Local Government in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3807. [PMID: 33917335 PMCID: PMC8038700 DOI: 10.3390/ijerph18073807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/28/2021] [Accepted: 04/02/2021] [Indexed: 11/16/2022]
Abstract
The promotion of walking and cycling to stay active and mobile offers great potential for healthy aging. Intersectoral collaboration for age-friendly urban planning is required in local government to realize this potential. Semi-structured interviews were conducted with the heads of planning and public health departments in city and district administrations of a Metropolitan Region in Germany to identify factors influencing action on the cross-cutting issue of active mobility for healthy aging. Although some administrations are working on the promotion of active mobility, they consider neither the needs of older people nor health effects. A lack of human resources and expertise, mainly due to the low priority placed on the issue, are described as the main barriers for further strategic collaboration. Furthermore, the public health sector often focuses on pathogens as the cause of morbidity and mortality, reducing their acceptance of responsibility for the topic. Facilitating factors include the establishment of new administrative structures, projects with rapid results that create awareness and credibility among citizens and politicians, additional staff with expertise in health promotion, and political commitment. In the future, new administrative structures for intersectoral collaboration are needed in order to consider various perspectives in complex developments, such as healthy aging, and to benefit from synergies.
Collapse
Affiliation(s)
- Tanja Brüchert
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (S.B.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Paula Quentin
- Faculty of Spatial Planning, Department of Urban and Regional Planning, TU Dortmund University, August-Schmidt-Straße 10, 44227 Dortmund, Germany;
| | - Sabine Baumgart
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (S.B.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
- ARL—Academy for Territorial Development in the Leibniz Association, 30179 Hannover, Germany
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (S.B.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| |
Collapse
|