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The Social and Built Environment in an Older Society (1988)

Chapter: THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED

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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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Suggested Citation:"THE ROLE OF TRANSPORTATION IN THE SOCIAL INTEGRATION OF THE AGED." Institute of Medicine. 1988. The Social and Built Environment in an Older Society. Washington, DC: The National Academies Press. doi: 10.17226/1012.
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The Role of Transportation in the Social integration of lithe Aged Martin Wachs Mobility, the ability to travel from place to place, is a basic determinant of the quality of life in old age, yet it is often overlooked in discussions of the social and built environment. Perhaps this oversight occurs because mobility does not give us satisfaction in its own right. Few people drive on freeways or ride buses because they value these experiences; we value in- stead excellent health care, housing, and recreational activities. Mobility is valued, in turn, as a link to other elements of the built and social environments. Thus, transportation may be the means by which our environment conspires to isolate the elderly or one of the keys to an active and healthy old age. Just a century ago, the city was primarily a "walking city." Most people walked between home and work, to do their shop- ping, to schools and churches. Within a very short period of time in fact, within the memory of many still living the city has been transformed by transportation and communications technology. First, streetcars enabled people to live and work in separate quarters of the city. Later, trucks and telephones freed businesses of their dependency on downtown locations. By 1930 the auto had become the primary means of transportation for Martin Wachs is a professor in the Graduate School of Architecture and Urban Planning, University of California, Los Angeles. 169

170 MARTIN WACHS most families, and the location and scale of shopping centers, social activities, and human services have evolved to reflect nearly universal access by means of the automobile. Low-density residential areas, decentralized health care, diversified regional shopping centers, and suburban office centers work quite well for those who drive without difficulty. Yet these same structures provide a harsh environment for people whose lives differ signif- icantly from the norm of the suburban, auto-oriented household. The very poor, ethnic minorities, disabled people, and many of our elderly are isolated in a world that assumes that the two- car, two-worker, two-child, two-story household in suburbia is typical and caters only to it (Schaefer and ScIar, 19751. Because travel in our society is largely derived from the pro- duction and consumption of other goods and services and is rarely an end in itself, we must be careful when interpreting statistics about travel patterns. We can be pretty certain that a household having less wealth and income than another is likely to have a lesser degree of well-being, but it does not follow that a household that travels less than another has a Tower degree of mobility. A person's mobility should be judged by the extent to which his or her need to travel is being met and not by how much he or she travels in comparison with others. Surprisingly, the fact that many old people travel less than many younger people is often interpreted as a lack of mobility when it should be obvious that relief from the traditional morning and evening commute is for most people a blessing rather than a deprivation. The critical question is not how much elderly people travel but whether or not mobility limitations restrict their freedom of choice and, hence, the quality of their lives. The following para- graphs summarize some of the major differences between the travel patterns of the elderly and other population groups, and interpret these differences in an effort to gain greater under- standing of the mobility patterns and needs of the elderly. Later sections of the paper review national policies for improving the mobility of the elderly in an effort to suggest some directions for possible improvement, especially with respect to the integra- tion of transportation requirements in the planning of housing for the elderly.

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION INTERPRETING TRAVEL BY THE ELDERLY AND DETERMINING NEEDS 171 The 1977 Nationwide Personal Transportation Study (NPTS) of more than 20,000 households shows that travel patterns change dramatically during a person's life cycle. For example, childless couples in their twenties on average make about four trips per day totaling approximately 36 miles of travel. Travel peaks among families with children and whose heads are in their late thirties. Such families on average make a dozen trips per day and travel nearly a hundred miles daily. Households of very old people typically make the smallest number of trips per day and travel the fewest miles. Couples in their eighties, for example, average about one trip per day for a total of about 3 miles of travel (Zimmerman, 19811. Such figures, as indicated above, do not necessarily indicate relative deprivation in mobil- ity among the aged and may reveal more about changes in activity patterns than about mobility and aging. At every stage in the life cycle, household travel patterns are correlated with a few key variables. Travel is always statisti- cally associated with the number of automobiles owned by a household and in turn, this variable is most often highly depend- ent on household size and income. In statistical terms, then, we often find that households consisting of elderly people travel less than households consisting of younger people in large part because they are smaller households and they have fewer work- ers, fewer automobiles, and less disposable income. It is hard to prove that aging directly affects one's propensity to travel but easier to identify with elderly households certain economic and demographic characteristics that are associated with reduced travel. One-third of all trips and about 40 percent of all vehicle mile- age are associated with earning a living the trips made to and from work and the trips made while on the job. Because old people are less likely to be working, these trips are eliminated from their travel patterns. Similarly, social and recreational travel exhibits a marked decline with age. Married couples in their seventies make fewer than half as many social and recre- ational trips as married couples in their thirties. The one com- ponent of travel that seems invariant with age is "family busi

172 MARTIN WACHS ness," which includes trips for shopping, medical care, and banking. The NPTS showed, for example, that single people in their seventies who lived alone made about the same number of trips for these purposes as single people in their twenties who lived alone (Zimmerman, 19811. These data may illustrate that declines in aggregate travel by elderly people are mostly associ- ated with retirement from work and changes in social and rec- reational preferences. The trips that the elderly consider to be most essential seem to continue to be made. Mobility may well be a severe problem for many elderly people, but the dimensions of the problem cannot be grasped fully by the aggregate analysis of travel patterns alone. COMMON STEREOTYPES OF THE ELDERLY AND THEIR MOBILITY NEEDS The mobility problems of the elderly are complex and in some cases severe, but the conventional wisdom regarding such prob- lems is dominated by stereotypes that are for the most part untrue. The elderly are frequently portrayed as "transit depend- ent," people who have "given up" their cars as they reach retire- ment age, in part because of declining vision and reflexes and increasing fears about the dangers of driving. The reality is that most Americans of all ages make the vast majority of their trips in automobiles. In the aggregate, we make 84 percent of our trips in cars; we make 9 percent of our trips walking and use public transit for only about 3 percent of our trips (Klinger et al., 19821. The elderly do not appear to be substantially less reliant on automobiles than are younger people. In my own research on travel patterns in Los Angeles, for example, ~ found that 89 percent of all vehicle trips made by people over the age of 65 were made in automobiles, although the elderly were more likely than younger groups to be passengers and somewhat less likely to be drivers. Only 7 percent of the trips by older people in Los Angeles were made on public transit. Although this is still twice the proportion that characterizes younger groups, it is still a small percentage of all the trips made by the elderly (Wachs, 1979, p. 501. The physical changes that accompany aging do eventually rob people of the ability to drive an automobile safely and comfort- ably, but these changes occur gradually over many years. The

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 173 vast majority of drivers are able to continue operating cars well into their seventies, and many keep driving into their eighties. There are few physiological or medical reasons to associate tran- sit dependency with retirement status, but many public policy- makers often make this association. Perhaps because elderly people do not travel for work-related purposes and this type of travel is for most Americans the most common type, reductions in the volume of travel during the early years of retirement are mistaken for reductions in the ability to travel, especially by automobile. The stereotype of a transit-dependent elderly population may also in large part be drawn from the fact that more than 90 percent of all people in their thirties, forties, and fifties are licensed to drive and less than half of the population over the age of 70 is so licensed. ~ believe, however, that we are misinter- preting this difference if we attribute it to the process of aging. Many of today's elderly people never learned to drive, having grown up before automobile driving was as universal as it is today. The fact that this pattern is culturally determined and not an inherent function of the aging process is illustrated by the difference between the rates of elderly men and elderly women who are licensed to drive. Only 33 percent of women over the age of 70 are licensed to drive, but nearly 70 percent of men in this age group are presently licensed to drive (Asin, 19801. In the early years of the automobile, it was far less common for women to learn to drive, and most of the elderly women who do not drive have never done so. Because women outnumber men quite substantially in the older age groups, women who never drove dominate the nondriving component of the elderly. By comparison, among people in their thirties, forties, and fifties, there are almost no differences in the proportions of men and women who possess driver's licenses (Asin, 19801. More than 90 percent of men and women in these age groups have licenses. Thus, we would conclude that as the present elderly are replaced by the next generation, a much larger percentage of the total elderly population will consist of people having driver's licenses and that the biggest difference will be among women. Looking at vehicle ownership as another indicator of relative mobility, a pattern similar to that for driver's licenses may be seen. Although the elderly appear to be relatively less mobile than younger people, as a group, they are hardly transit depend

174 MARTIN WACHS ent. About two-thirds of American households headed by people over the age of 65 own at least one automobile, and about one- third own no automobiles (Motor Vehicle Manufacturers Associ- ation, 1984, p. 43~. The rate of carlessness is more than twice as high for those over the age of 65 as it is for those in their fifties, but it is difficult to classify a group as transit dependent when two-thirds of its members own vehicles. In addition, T believe that many of these households (the one-third who own no cars) never owned autos and that they will be replaced in the coming decades by older people who enter the retirement years possess- ing automobiles. Because many of today's elderly live in denser central-city neighborhoods and do not drive, and a greater proportion of the younger population lives in the suburbs and does drive, it is often said that elderly people give up their suburban communi- ties and relocate to central-city areas after retirement when the decline in their mobility forces them to live closer to essential services. This may be true for some older people, but as a gen- eralization, the picture is more in error than it is accurate. A simple examination of census data indicates that differences with age between suburban low-density living and inner-city high-density living have little to do with the process of aging. Rather, the observed pattern is explained more accurately by major economic and cultural differences among population co- horts. Census data on tenure of residence show that most of today's transit-dependent inner-city elderly have lived at their present addresses for decades. They are largely people who grew older at their central-city locations, and they include many who never drove and never lived in the suburbs. The suburbs are largely inhabited by different cohorts of people, many of whom are beginning to reach retirement age and most of whom have been driving for decades. Rather than concluding that these people will become less mobile and move to inner-city neighbor- hoods served by transit, it appears more likely that they will continue to live at low densities and continue to drive through- out their sixties and seventies and into their eighties. ~ believe that the population will continue to suburbanize dur- ing the coming decades, resulting in more and more elderly suburbanites. This process will occur, despite frequent predic- tions of the revival of the inner city, because of the basic eco- nomic relationship between housing and mobility. During the

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 175 past 20 years, "typical" American family budgets for low-, mid- dle-, and upper-income households have devoted more than 20 percent of total expenditures to housing and about 6 to ~ percent of total expenditures to transportation. During the same years, trends in the consumer price index reveal that the price of hous- ing has multiplied by a factor of four while transportation prices have roughly doubled. Despite the well-known effects of the en- ergy crises on the prices of gasoline, then, the reality is that housing is both a larger item of household expenditure than is travel, and it is becoming relatively more expensive over time. Because the cost of housing generally declines as distance in- creases from the center of the city, it remains economically ra- tional for most American households to trade increases in the cost of transportation for decreases in the unit cost of housing by moving farther from downtown in order to get more housing for their housing budget. As developers recognize this trend, they put up smaller and denser housing units in the suburbs, and each year the population continues to move farther from the city centers. By focusing attention on the stereotype of the elderly as a relatively carless, nondriving, transit-dependent group in a rel- atively car-owning and -driving world, we often fail to take note of the fact that old people are an incredibly diverse group with life-styles and behavior patterns that are as varied as those of any age group. By focusing on the richness of this diversity instead of the simplistic stereotype, we may arrive at a com- pletely different understanding of the mobility patterns and needs of old people. Let me illustrate this by focusing on the mobility patterns of the elderly in the inner city versus the elderly of the suburbs. MOBILITY PROBLEMS OF THE INNER-CITY ELDERLY The elderly of our inner cities include many people who are transit dependent and accustomed to the high density of activi- ties and neighborhood services that characterized urban neigh- borhoods of the early decades of this century. Many of these people grew older with their communities and never experienced the total automobile orientation that characterizes later gener- ations more accustomed to suburban low-density living. Many

176 MARTIN WACHS of the inner-city elderly are widows whose husbands did drive. These women experienced a severe blow to their mobility when their husbands died, separating them from their access to auto- mobiles as well as from their lifetime partners. Also included among the inner-city population are most of our ethnic minority elderly, including those who grew older with their communities and some who arrived rather late in life as part of multigenera- tional households that migrated to the barrios and ghettos of larger cities. Many of the urban elderly are mobility dependent. Having never driven, and being economically limited to using taxis only for rare emergency trips, these people must rely on the public transit system and on relatives or friends who drive. By depend- ing to some extent on others to drive them, elderly people in this situation suffer substantial reductions in their freedom of choice. Spontaneity is an important ingredient of mobility, consisting, as it does, of the ability to decide at a moment's notice that a trip to a doctor, park, or theater would be appropriate. Depend- ing on a child or a friend to provide transportation to such activities usually means accommodating to their availability and perhaps deferring a trip when a lift is not available. This dependency becomes part of the psychological sense of depend- ency widely associated with aging. It explains why, in a number of attitudinal studies, elderly respondents have reported that accepting rides from others was more convenient and less phys- ically demanding than using public transit, but it also made the respondents feel that it put them under an obligation that they would not repay, or saddled them with feelings of indebtedness (Carp, 1972a, 1972b). Although public transit may allow for greater spontaneity than dependence on friends or relatives who drive, it is fraught with additional problems for many old people. First, and most obvi- ously, a person who uses public transportation is limited to choosing destinations that are served by such transit and to traveling at hours of the day when service is conveniently avail- able. These constraints do limit one's choices, as ~ found in a study that T did a number of years ago. When T calculated, for example, how many hospitals and clinics a person could reach from the center of a low-income, inner-city community by bus versus by automobile, relying on published bus schedules and actual driving times at the noon hour on a typical weekday, ~

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 177 found that a person could reach 40 hospitals and clinics within 15 minutes of driving time but only 2 within a similar travel period using public transit. If the acceptable access time was lengthened to 30 minutes, the citizen of this neighborhood could reach 143 hospital's and clinics with a car but only 14 by transit service. The point is not that an individual needs to use a large number of facilities in the course of his or her daily activities but rather that the automobile provides much greater freedom of choice than transit. The transit-dependent elderly person must either choose from a smaller number of available hospitals (or parks, theaters, and educational facilities) or invest a much larger amount of time in traveling than automobile users spend on such efforts (Wachs and Kumagai, 19731. A second problem with public transit is that it may involve substantial physical barriers that are difficult or impossible for some elderly people to surmount. Because buses and rail sys- tems operate on fixed routes that generally are not designed around the travel patterns of particular citizens, many elderly people must walk Tong distances, exposed to cold, heat, or rain, involving hills, stairs, and broad, busy streets to cross. The vast majority of people who are classified as elderly by virtue of being age 65 or older can easily negotiate the urban landscape, but we have a special interest in those who cannot. As life expectancy lengthens and more and more inner-city elderly peo- ple are in their eighties, the physical barriers involved in transit travel become extremely significant factors. A national survey conducted for the U.S. Department of Transportation's Urban Mass Transportation Administration (1978) found that 7.4 mil- lion persons living in the urban areas of the United States were physically 'limited in their ability to use public transportation. Although this number included many people who were young, some 47 percent were over the age of 65, and 67 percent were over the age of 55. About one-fifth of these people were physi- cally unable to use public transit at all; an additional 30 percent did use transit but only with considerable physical difficulty or discomfort. Elderly people who depend on public transit face another bar- rier to mobility that is perhaps the most distressing of all and that has only recently been studied. It appears that transit pa- trons are frequently victimized by criminals who prey on people walking to and from bus and train stops, waiting at transit

178 MARTIN WACHS stops, and riding on transit vehicles. Many elderly people report that they are fearful of using public transit, especially after dark, and their fears appear to be well founded. ~ recently con- ducted a survey of more than a thousand households in a central portion of Los Angeles that is well served by transit and densely populated by people of a variety of income levels and ethnic groups (Levine and Wachs, 19851. The area, like many inner-city communities, contains a large number of households headed by elderly people. The results of the survey were astounding. Add- ing up the crimes respondents reported had occurred walking to and from bus stops, waiting at bus stops, and riding on buses, my coworkers and ~ discovered that incidence rates among our sample were 30 times the crime victimization rates reported by the local transit police. The gap between the reported crime rates and the responses to our survey were attributable to poor reporting of crimes by the victims and by the police failing to categorize crimes as being related to transit travel. The findings showed that 17 percent of those who used the bus regularly had been victims of a crime during the previous 3 years. Among the respondents to the survey who were over the age of 65, 20 per- cent had been victimized in that time period; among the respon- dents under the age of 30, only ~ percent had been so victimized. It is clear that the elderly are victims of crime while traveling on public transit to a far greater extent than other groups. Their greater vulnerability occurs in part because the elderly make up a disproportionate share of transit users, being relatively transit dependent, but it also happens because the elderly are singled out as easier targets by criminals. Most of the crimes committed against all age groups were purse snatchings and pickpocketings; as a rule, they did not involve injuries, but sub- stantial numbers of victims reported being pushed, shoved, punched, and threatened with weapons. To sum up, the inner-city elderly, who include a relatively small proportion of car owners and drivers, have a mobility problem related to their dependency on public transit or on others to drive them. This dependency reduces their mobility because it reduces individual control over decision making and spontaneity in travel. Depending on public transit means accept- ing a limited selection of possible destinations, negotiating phys- ical barriers that for some may be substantial, and exposing oneself to the risks of victimization by criminals.

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION MOBILITY PROBLEMS OF THE SUBURBAN ELDERLY 179 The majority of people reaching retirement age today are not the inner-city, transit-dependent elderly. They are suburban, and most typify what Bernice Neugarten describes as the "young old." They are classified as elderly by their chronological age but are active and healthy, the kind of people likely to take advantage of senior citizen discounts at theaters and sporting events. They are, for the most part, mobile because most of them both own and drive automobiles. Each year, there are more and more of these active, mobile elderly, including larger and larger numbers of people who adopted Tow-density, suburban life-styles decades ago and who continue to live in the suburbs well into their retirement years. Most have no difficulty thriving in envi- ronments that lack public transportation and in which the doc- tor and supermarket may be located many miles from their residences. My studies of the elderly of Los Angeles County indicated that about half of the elderly there are already to be found in such environments, that they are roughly twice as likely to have driver's licenses than the central-city elderly, and that they make two to three times as many vehicle trips per household per day as the inner-city elderly (Wachs, 1979, chap- ters 3 and 51. In rough terms, by the turn of the next century, the number of suburban low-density, auto-oriented elderly will more than double, and the number of transit-dependent inner- city elderly will decrease in absolute numbers and decrease even more dramatically as a proportion of the total elderly population. The mobility problems of this group will arise later in life, as increasing numbers of them survive into their late seventies, eighties, and nineties. When failing vision and increasing frailty ultimately make it impossible for them to drive, these people can become in relative terms, and rather suddenly, more isolated and dependent on others than the inner-city elderly who may never have driven cars. Because their life-styTes were more de- pendent on their ability to drive and, consequently, they chose to reside in environments having lower densities of services in close proximity to residences, a greater void is left in their lives when they can no longer drive. Because of these Tow densities, medical care and shopping is even harder to reach than it is in the inner city, and for the same reason it is far more costly for

180 MARTIN WACHS public agencies to operate transit in such areas. Many who are deprived relatively late in life of their mobility are forced to relocate, move in with their children or other relatives, or move into congregate living facilities. The trauma of such moves is accentuated because they come relatively late in life and be- cause they are forced on an individual by a lack of mobility rather than being the result of preference. The fact that this population enjoys mobility the longest of any of the elderly does not make the ultimate adjustment to its Toss easier, and it is interesting to note that each year a larger and larger number of us will face just such an adjustment. NATIONAL POLICY ON THE MOBILITY NEEDS OF THE ELDERLY For 20 or more years, meeting the mobility needs of the elderly has been an explicit element of national transportation policy. Yet despite this commitment, there is no clear consensus on the most efficient ways to use public resources to accomplish our goals. There is also widespread disappointment that the hun- dreds of millions of dollars that have already been spent have resulted in little tangible progress. The subject has become highly politicized, and it is difficult to take a position on the issue without appearing to "take sides." In 1968 Congress adopted the Architectural Barriers Act, which was intended to ensure reasonable access to public build- ings by physically handicapped people. Passage of the law was the first result of a series of political actions that included nu- merous lawsuits, legislation, and regulations affecting the tran- sit industry. In San Francisco, for example, a bitter fight took place over the question of wheelchair access to BART stations and cars, and in 1970 Congress amended the basic Urban Mass Transportation Act of 1964 to declare that "it is national policy that elderly and handicapped persons have the same right as other persons to utilize mass transportation facilities and serv- ices; that special efforts have to be made in the planning and design of mass transportation facilities and services so that the availability to elderly and handicpped persons of mass transpor- tation which they can effectively utilize will be assured."2 Yet the broad national policy stated here did not specify how agen- cies and transportation authorities were to meet the needs of

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 181 the elderly, and that omission has been the source of a bitter debate that remains unresolved despite numerous revisions of federal regulations and thousands of hearings, court cases, and scholarly analyses. One source of difficulty has been the lumping together of "el- derly and handicapped" in this policy statement, as though these citizens by definition had identical mobility needs. The majority of the elderly are not handicapped, and the majority of the handicapped are not elderly. Labeling the two as one group has several negative effects. First, it stigmatizes the elderly who deserve and demand to be considered a group with unique char- acteristics and who vigorously assert that aging is not a handi- cap but a normal part of living. The label also focuses the atten- tion of transportation planners and managers on the physical requirements of the handicapped and associates the removal of physical barriers to travel with the attainment of all of the mobility needs of the elderly. Efforts to remove physical barriers to travel certainly deserve applause, but proper consideration of the needs of the elderly can hardly be limited to the removal of physical barriers. Nevertheless, although lumping together the "elderly and handicapped" has harmful effects, it must also be observed that it has probably resulted in more attention for the transportation needs of older people than would otherwise be the case. It is much easier to capture policymakers' attention when speaking for disabled veterans, the blind, and the deaf instead of competing with these groups for attention. The tension over labeling the elderly as synonymous with the handicapped is part of the background for what we might call "the great debate" in the field of mobility for these groups. This debate, which has been raging for decades and is far from reso- Jution, is between the proponents of "mainstreaming" or total accessibility on the one hand and those advocating the provision of separate specialized services for the elderly on the other. The proponents of total accessibility or mainstreaming argue that the law requires all transit facilities and equipment to be totally accessible to the elderly and handicapped and that emphasis should be placed on the removal of all architectural barriers and the equipping of all buses with wheelchair lifts. Others argue that changing the entire public transit infrastructure to accom- modate wheelchairs will cost billions and that it will provide inferior service for the elderly and handicapped in comparison

182 MARTIN WACHS to separate door-to-door services, which are available exclusively to these groups (Fielding, 19821. The cost of mainstreaming has been vigorously debated, but it is certainly high. Transit agen- cies have purchased wheelchair lifts for thousands of buses at an extra cost per vehicle that is reported to be in the range of $12,000 and that involves annual maintenance costs ranging from $500 to $4,000. The lifts reduce the seating capacity of buses, and their use slows travel for all passengers on the vehicle. Furthermore, the use of these buses by the handicapped has been low. One transit company, for example, which has about 120 lift-equipped buses, reported that the lifts are actually de- ployed to serve one to four handicapped riders per day through- out its entire system; the nation's largest all-bus transit system in Los Angeles carries 51 daily wheelchair users although ap- proximately 1,900 of its total fleet of 2,600 buses are equipped with wheelchair lifts (Southern California Rapid Transit Dis- trict, 1984, p. 241. The lifts have been unreliable, and handi- capped riders have been embarrassed by the delays they cause other passengers when wheelchair lifts are operated. In addi- tion, surveys of the handicapped have shown that wheelchair occupants usually find it difficult to get from their homes to bus stops, certainly hindering their use of fixed-route "mainstream" service in comparison with separate fleets providing door-to-door service (Wachs, 19791. The Congressional Budget Office (1979) estimated that it would take 30 years and over $7 billion to achieve full wheelchair access to the nation's transit systems. The American Public Transit Association reported that the av- erage capital and operating cost per trip by handicapped people among five transit agencies was over $700, primarily because of the low rates at which the facilities were actually utilized. For nearly 20 years, a variety of draft regulations, adopted regulations, lawsuits, amendments to legislation, and public de- bates have come in rapid succession. They demonstrate the clear differences between the transit industry's perspective, which emphasizes the cost-effectiveness of separate door-to-door sys- tems, and the activist's perspective, which emphasizes main- streaming and full accessibility as a basic human right (Rosen- bloom, 19821. In 1983 proposals to amend the requirements for providing service to the elderly and handicapped were again made, al- though they still await adoption because of continuing contro

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 183 versy. The proposed regulations would require transit operators to provide separate paratransit services for the elderly and handicapped or to offer a combination of wheelchair lifts and paratransit. Whichever option were to be chosen by the operator, the transit agency would not be required to spend more than 7.1 percent of its federal financial assistance, nor more than 3 per- cent of the agency's annual operating budget, on expenditures to meet the needs of the elderly and handicapped. These limits would constitute an uneasy compromise between activist and management perspectives. Because of the heated political cTi- mate in which decision making on this issue has taken place, it has taken more than 20 years of debate, legislation, and litiga- tion, and billions in public spending, to arrive at this accommo- dation. In the end, however, the compromise would appear to ensure rather little in the way of mobility to the elderly. A second element of transportation policy for the elderly and the handicapped has been the requirement that these groups be offered lower fares than the general public on existing public transit systems. Under current regulations, to be eligible for federal transit operating assistance under Section 5 of the Ur- ban Mass Transportation Act (as amended), the operator must provide elderly riders with fare reductions (they must not pay more than half the regular fares during nonpeak hours). In fact, many transit companies charge lower fares than required by the regulation, and many extend the fare reduction to the rush hour as well as to nonrush-hour periods. The emphasis on fare reduc- tions, like the removal of physical barriers, is of great impor- tance to a segment of the elderly in this case, the elderly whose use of transit is limited by small disposable income. Yet reduced fares do little to improve transportation service for those who receive infrequent, sparse, or nonexistent transit service. Tn- deed, the requirement that they receive Tower fares for serving elderly passengers might even discourage transit companies in some cases from making special efforts to improve those services that are tailored to meeting the needs of the elderly. Public transit service in the United States covers less than half of its operating costs from the fares its passengers pay, the majority of the costs being borne by subsidies. If a transit company must charge its elderly riders only half the normal fare and receives no special subsidy for carrying a larger number of elderly pas- sengers, it faces the prospect of increasing deficits if it spends

184 MARTIN WACHS money for improvements that will bring additional elderly ri- ders. Although reduced fares for the elderly seem a benefit, they actually result in larger economic Tosses as more passengers are served, and they clearly discourage transit managers from being creative in trying to serve larger markets of elderly patrons. Another area in which a national commitment has been made to the provision of transportation services for the elderly is the financial support of specialized paratransit services operated by social services agencies, volunteer organizations, and municipal- ities across the nation. Using funds available through the Older Americans Act, the Social Security Act, the Housing and Com- munity Development Act, and hundreds of state and local sta- tutes, senior citizen centers, health care facilities, veterans pro- grams, and many other groups operate their own door-to-door transportation services. A variety of researchers have shown that we are spending perhaps a billion dollars per year on such services, most employing vans and drivers in fleets of a few vehicles. Studies have consistently shown that there is a great deal of duplication and inefficiency in what has come to be called the "social services" transportation sector. The small scale of operations, low patronage rates, inexperienced staff, and re- luctance to rely on larger public agencies for transportation services have made it difficult to overcome the high costs of such services by forcing "coordination" as a condition for receiving subsidies. A number of studies have shown that efforts to force mergers or consolidations of specialized transit operations have been met with institutional resistance, and, ultimately, the costs of consolidation and cooperation have been so high that they tend to eliminate all of the benefits anticipated from these poli- cies. In the social services sector, the cost of providing a ride to a senior center or health care facility is often on the order of $20 or more; in newer, smaller, and inexperienced systems, it is often closer to $100. Yet the rides are often provided free or for a token fare of 50 cents or a dollar. The reality, then, is that most Americans over the age of 65 provide their own transportation through private automobiles. For most, such provision is not a problem, and it is consistent with their life-styTes prior to old age. For those who are unable to drive, however, the choices remain limited, and there is little prospect for dramatic improvement. Some can rely on traditional fixed-route public transit, but they are then limited in their

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 185 travels to visiting those destinations that are served by transit. Reduced fares and the removal of architectural barriers are in- creasing the proportion of the elderIv Copulation that is able to use public transit, but the increase is small in relation to the cost. Tn addition, those who rely on public transit to fulfill their travel requirements run a high risk of becoming the victims of crimes. Social services agencies frequently provide specialized door-to-door transportation services for their clients, and these services do overcome the physical barriers and safety problem of many public transit users. Yet the costs are enormous, and when the services are considered in combination, it is clear that they are least able to meet the needs of the growing number of iso- lated elderly people in suburbia the former drivers who live in Tow-density areas reached by few public transit routes and few social services transportation agencies. RESEARCH DIRECTIONS IN HOUSING/ MOBILITY TRADE-OFFS An active and satisfying old age requires the opportunity to engage in a variety of activities at reasonable costs in terms of effort, time, and money. Older people are diverse in their life styles, needs, and preferences, and it is therefore difficult to prescribe an appropriate type and level of mobility. We must be equally understanding of and attentive to the needs for social integration of active and mobile recent retirees and of house- bound disabled people, even though the two groups may have very different needs. Funding arrangements and legal require- ments must be more flexible than they have been to date. The diversity of mobility needs among the elderly indicate that by prescribing narrowly defined programs we are limiting the op- portunities of those whose needs are not addressed under those programs. In general, elderly people meet most of their travel needs by private means: walking, driving, and being driven by friends and relatives. Because each year an increasing proportion of elderly people own and operate automobiles, cars are likely to remain the major source of mobility in coming decades. As a result, more research is needed on the aging driver to provide a better understanding of the physiological, sensory, and attitudi- nal aspects of driving in old age. We could, perhaps, do a better

186 MARTIN WACHS job of designing automobiles, highways, and traffic control sys- tems to reflect the fact that the proportion of drivers who are old is increasing more rapidly than the proportion of the popu- lation that is old. Motor vehicle accidents are the leading cause of accidental deaths for people over the age of 65, as they are for younger people, and they account for half the accidental deaths among people over the age of 75. Older people are physically vulnerable and are more likely than younger people to be killed when involved in a car crash. Although people over 65 account for 7 percent of those involved in accidents, they account for 12 percent of those killed. And in fatal accidents in which one driver is over the age of 65, it is reported that the older driver is 3.5 times more likely than the younger driver to be killed (KoTtnow, 1985, p. 211. Automobile manufacturers, for example, do surprisingly little research on product design for elderly driv- ers, offer few options specifically tailored to old people, and devote a surprisingly small proportion of their budgets to mar- ket research targeted to an older market. In a society in which the automobile is nearly universal, we know relatively little of the psychological and behavioral effects of the declining ability to drive in advanced old age or the effects of declining driving skills on housing and locational decisions. These are both fruitful areas for research in the coming years. The Transportation Research Board is planning a 2-year study to review research on and experience with older drivers and pedestrians and to recommend actions that should be taken on the basis of future population characteristics. This research could be an extremely important undertaking. Traditional public transit, which usually involves fixed-route, scheduled bus and rail service, meets another share of the mo- bility needs of the elderly, especially in the inner cities. Efforts are proceeding slowly but surely to remove architectural barri- ers to public transit, but for many, these services are difficult to get to, frightening to use, and limiting to the extent that they cannot serve every destination. To date, research has focused on the physical mobility of the elderly to use transit vehicles; much more is to be learned regarding the elderly user's attitudes to- ward transit service improvements. T believe, for example, that a well-founded fear of crime is one of the greatest barriers to transit use by older people and that greater attention to security might be one of the most important directions for public policy

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 187 makers attempting to better tailor transportation for the el- derly. More market research is needed on the social and psycho- logical barriers as well as the physical barriers to the use of conventional public transit by older people. Although they provide fewer trips for elderly people than autos or transit vehicles, specialized paratransit services provide crit- ical door-to-door services for those having more severe mobility limitations. To date, however, these services have been limited in their geographic coverage and limited to certain types of trips and clients and to those making advanced reservations. In ad- dition, in many cases, such services have been duplicative, ex- pensive, and inefficient. Efforts to coordinate and consolidate services of this type have had limited success. The most promis- ing area for improvement is in what economists call "user-side" or "demand-side" subsidies. Under these subsidy plans, clients are provided, at low or moderate cost, with vouchers or coupons they can use to purchase taxi rides, bus rides, or specialized escorted van rides within a fairly large jurisdiction and without limits as to trip purpose. The service operators are reimbursed for the services actually provided. Although a subsidy is in- volved and there is some potential for fraud, this type of mecha- nism has a potential for flexibility and efficiency that is matched by few current social service agency transportation services. To some extent, retirement communities and congregate living facilities provide collective transportation services for their re- sidents that take the place of private automobiles and substitute for door-to-door paratransit services. Transportation provided in this manner becomes part of the infrastructure of housing serv- ices. In some instances, regular shuttle services are provided to nearby transit stations or shopping centers; in other cases, reg- ularly scheduled recreational outings are provided; and at least one large San Francisco housing development has compact autos available for rent to its residents at short notice on an hourly or daily basis. We know relatively little about the economics of such transportation services or about the size of the community at which it becomes economically feasible to incorporate trans- portation services with housing. Case study research and sys- tematic comparisons of such services with traditional transit options would reveal a great deal about the potentials and the limits of integrating mobility into the residential environment. Today, for those who are most severely limited in mobility, we

188 MARTIN WACHS try to bring the services to the client instead of providing the client with mobility. Meals-on-wheels, home health care, and friendly visitor services all take the place of trips for those having the least mobility and the greatest need. These services are, of course, quite costly to provide, but they are critical to a small but important segment of the elderly. From my observa- tion, what such programs often need most is a stable funding base. So many in-home services are of such small scale and short duration that the bulk of staff time is devoted to proposal writ- ing and fundraising rather than the delivery of services. Housing and mobility are clearly interdependent elements of our social environment. If one chooses a Tow-density suburban living environment, far from friends, relatives, and services, it may entail high mobility costs for the individual and society, especially in old age. High-density inner-city environments may impose high housing costs and less aesthetically pleasing envi- ronments on their residents, but it may cost individuals and society much less to provide access to services at such locations. Although we recognize these principles, we know less than we would like to know about the economic, social, and cultural trade-offs between housing and mobility. Therefore, any investi- gation of the interrelationships between housing and mobility in old age must include attitudinal and social dimensions as well as physical and economic ones. NOTES 1. Public Law, 90-480, "Public Buildings: Accessibility to the Handicapped" (1968), 82 Stat. 718. 2. Public Law 91-453, "Urban Mass Transportation Act" (1970), 84 Stat. 962. REFERENCES Asin, R. H. 1980. Characteristics of 1977 Licensed Drivers and Their Travel. Report No. 1, Nationwide Personal Transportation Study. Washington, D.C.: U.S. Depart- ment of Transportation, Federal Highway Administration, Highway Statistics Division. Carp, F. 1972a. "Retired People as Automobile Passengers." The Gerontologist 12(1, Part 1). Carp, F. 1972b. "The Mobility of Older Slum Dwellers." The Gerontologist 12 (1, Part 1). Congressional Budget Office. 1979. Urban Transportation for Handicapped Persons: Alternative Federal Approaches. Washington, D.C.

TRANSPORTATION'S ROLE IN SOCIAL INTEGRATION 189 Fielding, G. 1982. "Transportation for the Handicapped: The Politics of Full Acces- sibility." Transportation Quarterly 36 (2, April):269-282. Klinger, D. J., et al. 1982. Household ISavel. Report No. 9, Nationwide Personal Transportation Study. Washington, D.C.: U.S. Department of Transportation, Fed- eral Highway Administration, Highway Statistics Division. Koltnow, P. G. 1985. "Improving Safety and Mobility for Older People." TR News 120(September/October):20-23. Levine, N., and M. Wachs. 1985. Factors Affecting the Incidence of Bus Crime in Los Angeles. Report No. CA-06-0195, Washington, D.C.: U.S. Department of Trar~spor- tation, Urban Mass Transportation Administration, Office of Technical Assis- tance, University Research and Training Program. Motor Vehicle Manufacturers Association. 1984. Motor Vehicle Facts and Figures '84. Detroit, Mich. Rosenbloom, S. 1982. "Federal Policies to Increase the Mobility of the Elderly and Handicapped." Journal of the American Planning Association 48(3, Summer):335- 350. Schaeffer, K. H., and E. Sclar. 1975. Access for All: Transportation and Urban Growth. Harmondsworth, England: Penguin Books. Southern California Rapid Transit District. 1984. Fare and Service Policies for the 1985 Fiscal Year. Staff Report and Discussion Paper. October 11. U.S. Department of Transportation, Urban Mass Transportation Administration. 1978. Technical Report of the National Survey of Transportation Handicapped Peo- ple. Prepared by Grey Advertising. Washington, D.C.: U.S. Department of Transportation. Wachs, M. 1979. Transportation for the Elderly: Changing Lifestyles, Changing Needs. Berkeley: University of California Press. Wachs, M., and T. G. Kumagai. 1973. "Physical Accessibility as a Social Indicatod' Socio-Economic Planning Sciences 7(5):437-456. Zimmerman, C. 1981. A Life Cycle of 15 avel by the American Family. Report No. 7, Nationwide Personal Transportation Study, Washington, D.C.: U.S. Department of Transportation, Federal Highway Administration, Highway Statistics Division.

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Third in the series, this book addresses the social implications of architectural and interpersonal environments for older people. It suggests how society and its structures can enhance the productivity of, and preserve the quality of life for, older residents in a community. The study investigates new approaches to the problem, including new housing alternatives and new strategies for reflecting the needs of the elderly in housing construction.

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