Women’s Issues in Transportation: Summary of the 4th International Conference, Volume 2: Technical Papers (2011)

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64 Gender Differences in Attitudes to and Mobility Impacts of Driving Cessation Jennifer Oxley, Monash University, Sunway Campus, Selangor Darul Ehsan, Malaysia Judith Charlton, Monash University, Clayton Campus, Victoria, Australia Safe travel is essential; however, recognition of the ben- efits of continued mobility and, conversely, the conse- quences of loss of mobility must also be considered. Driving affords the greatest mobility for many older adults. Unfortunately, at some point, most individuals need to consider retiring from driving. Although there are reported gender differences in the timing of and rea- sons for driving reduction and cessation, with potential impacts on mobility, health, and quality of life for some, much remains unknown about how older drivers per- ceive the difficulties in transitioning to being a nondriver and whether there are any gender differences in this process. Even less is known about how people decide to stop driving and the strategies that may improve the outcomes of this transition. This study examined gender differences in the mobility impacts of driving cessation and in life satisfaction. A total of 1,718 drivers (40% female) and 108 former drivers (58% female) completed a self-administered survey designed to examine issues surrounding the adoption of self-regulatory driving prac- tices and the mobility impacts of driving reduction and cessation. The study highlights gender differences in the processes of driving reduction and cessation, particularly driving frequency and experiences and plans for driv- ing cessation. While few gender differences were noted among former drivers, particularly in the number of trips and satisfaction with current mobility, older females were more likely than males to have planned ahead, made the decision themselves, and stopped at appropriate times, and to use alternative transport options, suggesting a good adjustment to nondriving with a more favorable mobility outcome. These findings have implications for the development of education and training programs to assist male and female drivers to achieve a smooth transi- tion from driving to nondriving. mobility is essential for general independence as well as for ensuring good health and quality of life. One of the most relevant and impor- tant activities of daily living for maintaining indepen- dence in most western societies is the ability to drive. For most seniors, driving represents not only a means of transportation but a fundamentally important sym- bol of autonomy, independence, and self-reliance and is a key facilitator of community inclusion. A wide body of research shows that many older adults in motorized countries rely heavily on driving for most of their trans- portation needs and that seniors are strongly interested in keeping their cars and licenses after retirement (1, 2). There is also good evidence that older people who are mobile and drive have fewer health problems such as osteoporosis and hip fractures and use fewer prescrip- tion drugs compared with those who do not drive (3). In addition, driving one’s own vehicle is associated with higher levels of life satisfaction, higher adjustment, less loneliness, and better-perceived control (4–8). While it is likely that a host of other age-related factors also play a role here, the ability to drive seems to contribute signifi- cantly to overall health and well-being. In contrast, forfeiture of driving privileges is con- sidered a major loss by many older adults in terms of social identification, control, and independence. There is

65ATTITUDES TO AnD mOBILITY ImpACTS OF DRIvInG CESSATIOn no doubt that many older people report strong feelings about the importance of driving and that the prospect of reduction and, more particularly, cessation of driving evokes a level of fear. For many, particularly those with a decline in health status, driving cessation is thought to contribute to poor psychological outlook, life satisfac- tion, community engagement, and quality of life and to increase depressive symptoms, feelings of isolation, loss of self-consciousness, and a decline in out-of-home activ- ity levels and community mobility (5, 9, 10). Further, for at least some people, the same health conditions and functional impairments that cause a change in driving patterns will also limit access to other transport options, such as walking, cycling, and public transport, thereby further contributing to restricted community mobility and its consequences. Driving status thus plays a critical role in the complex interactions between aging, physical and psychological health, community mobility, and use of health services. Given these factors, there is a strong emphasis around the world for older people not only to maintain their mobility for as long as possible, but also to ensure that they remain drivers for as long as it is safe to drive and reduce their driving and make the transition to nondriver status at appropriate times. How and when this decision is made is likely to have an important influence on a driver’s experience and adjustment to life without driv- ing. Indeed, evidence suggests that, with good planning and a good psychological outlook, the transition can be smooth and successful in reducing negative mobility con- sequences (11–13). An important consideration for those who manage older people’s safe mobility is the impact of individual differences and variables (such as gender) on mobility needs and decisions about driving reduction and ces- sation. Indeed, there are reported gender differences in crash and injury patterns, overall driving patterns, and the timing and processes of driving reduction and ces- sation. There is general consensus internationally that older female drivers are safer; have a higher likelihood of driving reduction, particularly driving in stressful con- ditions (14, 15); and have higher likelihood of voluntary cessation at a younger age, for less pressing reasons, and in better health as compared with older men (16, 17). There is also some evidence that some women may give up driving prematurely, even though they may still be capable of driving safely (18, 19). Some evidence suggests that there is a difference in quality of life between voluntarily giving up a license and having it revoked by the authorities, and that those who make the decision themselves and give up their license voluntarily are less likely to experience depression and loss of self-confidence and status to the same extent as those who have lost their license involuntarily (12). Little is known about these associations, however, and whether there are gender differences. It is possible that many older female drivers manage and plan the process of reducing and retiring from driving well, making the transition smoothly, with little stress and minimizing the loss of mobility. On the other hand, as suggested by Stutts et al. (18), some older women may experience more severe mobility consequences as a result of prema- ture driving cessation. This paper examines gender differences in the transi- tion from driver to nondriver status among a sample of Australian older seniors. Method This study surveyed seniors ages 60 years and older living in the Australian States of new South Wales (nSW) and victoria and in the Australian Capital Territory (ACT). participants for the survey were recruited through two main sources: the ACT Council on the Ageing national Seniors Office and the nSW Seniors Card Office, using the respective jurisdiction Seniors Card membership databases. In ACT and nSW, more than 90% of eligible seniors hold a Seniors Card, and the databases contain basic personal information on all ACT and nSW resi- dents who have membership to Seniors Card. To be eli- gible for an ACT or nSW Seniors Card, individuals must be age 60 years or older, be a permanent resident of ACT or nSW, and not be in paid employment for more than 20 hours per week. In addition, a smaller sample of for- mer drivers in the State of victoria was recruited through advertisements in seniors’ newspapers, auto club maga- zines, seniors’ clubs, retirement villages, and local gov- ernment aged care services. A questionnaire was designed to elicit information about driving patterns, self-regulatory driving practices, transportation needs, and decisions about driving cessa- tion. The questionnaire included both open-ended and closed-ended questions. Items included questions about demographic variables (e.g., age, gender, and place of residence), current driving patterns, recent crash and infringement history, recent changes in driving (distance, speed, and quality), and confidence in and avoidance of potentially difficult driving situations. To assess health status and functional abilities, seniors were asked to complete a checklist indicating the presence of specific medical conditions and to rate (excellent, good, fair, or poor) their overall health and functional abilities for safe driving, including vision for daytime driving, vision for nighttime driving, speed of decision making, upper and lower body strength, and head–neck movement. The questionnaire was self-administered by all par- ticipants in ACT and nSW; for participants in victoria, the questionnaire was conducted as a telephone inter- view by an experienced telephone interviewer. For the

66 WOMEN’S ISSUES IN TRANSPORTATION, VOLUME 2 self-administered survey, questionnaire packages includ- ing a cover letter, the questionnaire, a consent form for a follow-up interview, and a reply-paid envelope were sent to the respective Seniors Card agents and then mailed to a random selection of 3,000 older ACT residents and 3,000 older NSW residents. To target a representative sample of the population of older drivers and former drivers in ACT and NSW, the selection was stratified according to population-based gender and age groups for these jurisdictions. All participants were informed that their names had been randomly selected from the Seniors Card membership list and that personal details had not been given to any party. They were invited to complete the questionnaire if they were 60 years or older and either currently drove a car or had recently ceased driving (within the past 12 months). If they had never driven a car, they were asked to pass on the ques- tionnaire to another older driver or former driver who met the specified criteria. A total of 1,826 completed responses were returned, including 1,718 current driv- ers and 108 former drivers; 201 surveys were returned either unopened or incomplete. This represented a valid response rate of 27%. Regarding the sample of former drivers, an additional sample of 29 participants from Victoria who responded to a telephone interview were included in the analyses. In total, the combined sample included 1,718 current drivers and 137 former drivers. RESULTS Respondent Characteristics Respondents identified themselves as either a current driver or former driver (having given up driving within the past 12 months). Table 1 presents some demographic characteristics of both groups by gender. Overall, current drivers were younger—c2 [3 degrees of freedom (df)] = 123.3, p < .001—and more likely to be married [c2 (4 df) = 70.1, p < .001], compared with former drivers. Current drivers were also more likely to have achieved a higher educational level and less likely to be retired as compared with former drivers. Gender differences were also noted among the group of current drivers in terms of marital status [c2 (4 df) = 202.1, p < .001], age [c2 (3 df) = 32.8, p < .001], educa- tional level [c2 (3 df) = 24.6, p < .001], and employment status [c2 (3 df) = 26.5, p < .001]. In general, male driv- ers were more likely to be married, while females were more likely to be widowed. Female drivers tended to be younger than males, to have achieved a lower educa- tional level, and to be less likely to be working full time, and they engaged in more voluntary work than males. For former drivers, a gender difference was found for marital status only, where female respondents were more likely to be widowed as compared with males, who were more likely to be married [c2 (3 df) = 17.5, p < .01]. Travel Patterns Respondents were asked a number of questions relat- ing to their travel patterns and behavior and satisfaction with current mobility. Responses from current drivers regarding questions on driving distance, driving status, and use of other forms of transport are summarized by gender in Table 2. Female drivers were less likely than male drivers to drive longer distances. Only 53% of female drivers reported driv- ing more than 51 km each week, compared with 73% of TABLE 1 Characteristics of Current and Former Drivers, by Gender Percentage of Current Drivers Percentage of Former Drivers (n = 1,718) (n = 137) Characteristic Female Male Female Male Marital status Married 53.6 83.7 28.2 55.4 Divorced 12.4 6.5 17.9 10.7 Widowed 29.2 6.7 52.6 25.0 Never married 4.8 3.1 1.3 8.9 Age (years) <64 33.8 21.8 5.1 5.5 65–74 44.8 52.8 30.8 21.8 ≥75 21.4 25.4 64.1 72.7 Education level Primary school 6.7 6.8 17.6 14.3 High school 53.2 42.5 62.1 55.4 College 40.1 50.7 20.3 30.3 Employment status Retired 79.0 82.3 95.9 94.5 Part time 10.9 9.5 2.7 5.5 Full time 1.4 4.3 0 0 Volunteer 8.7 3.9 1.4 0

67ATTITUDES TO AND MOBILITY IMPACTS OF DRIVING CESSATION male drivers. Female drivers were also less likely than male drivers to consider themselves the main driver in the house- hold (70% versus 90%) and were less likely than male driv- ers to use other forms of transport (42% versus 49%). Among former drivers, almost all respondents (97%) indicated that their main form of transport was the pri- vate car, as a passenger. Other frequently used forms of transport reported were public transport (70% use), taxi (69% use), and walking (76%). No gender differences were found. Further, drivers and former drivers reported on their level of mobility. Figure 1 shows frequency of driving or going out by driver status and gender. Overall, there were significant differences in levels of mobility between the two groups [c2 (5 df) = 178.5, p < .001]. Only 30% of former drivers went out daily, compared with 68% of current drivers. Very few current drivers went out less than once or twice a week. Among the current driver group, there was a signifi- cant effect of gender on frequency of driving [c2 (5) = 23.2, p < .001]. Female drivers were less likely than male drivers to report driving daily or almost daily (62% ver- sus 72%, respectively), and more likely than male drivers to report driving 3 to 4 days a week (28% versus 19%, respectively). No significant effect of gender was found for level of mobility among former drivers. Respondents also indicated their satisfaction with their current level of mobility. First, current drivers were asked to describe how not being able to drive might affect them personally. The most frequent response categories cited by drivers were the following: • Restriction of activities (loss of freedom or conve- nience, or both), • Need to use public transport (more time consum- ing and difficult), TABLE 2 Travel Patterns and Behavior of Current Drivers, by Gender Variable Female Drivers (%) Male Drivers (%) Odds Ratio 95% Confidence Interval Driving distance (km per week) <50 46.2 26.2 >51 53.8 73.8 2.41 1.96–2.97 Driving status Main driver in household 70.7 90.2 Not main driver 29.3 9.8 3.80 2.91–4.97 Use of other forms of transport Yes 42.2 49.1 No 57.8 50.9 1.43 1.17–1.74 0 20 40 60 80 Daily or almost daily Three to four days a week Once or twice a week A few times a month Once a month or less Amount of Driving or Going Out Pr op or tio n Female current Male current Female former Male former FIGURE 1 Frequency of driving or going out, by driver status and gender.

68 WOMEN’S ISSUES IN TRANSPORTATION, VOLUME 2 • Need to change place of residence (no access to ser- vices where they currently live), and • Need to rely on family members for transportation. In addition, current drivers reported on level of driv- ing as compared with 5 years earlier (Figure 2), while former drivers rated their satisfaction with current abil- ity to get to places (Figure 3). Overall, the majority of current drivers (83%) felt that they were driving about an equal amount compared with 5 years earlier, and the majority of former drivers (74%) were either very satisfied or somewhat satisfied with their current level of mobility, with only about a quarter reporting dissatisfaction. Gender effects were found among current drivers [c2 (3 df) = 13.3, p < .01], but not among former drivers (p = 0.52). A greater pro- portion of male drivers than female drivers thought that they were driving the same amount as they were 5 years earlier (55% versus 51%, respectively), while a greater proportion of female drivers than male drivers thought they were driving more than previously (13% versus 9%, respectively). While there were no significant gender differences regarding satisfaction with current mobility amongst former drivers, there was some suggestion that men reported higher satisfaction than women. Driving Reduction and Cessation An important factor in successfully reducing and retir- ing from driving is planning ahead. Drivers were asked whether they had thought about the possibility of not driving one day, and 61% indicated that they had given some thought to this. Age and gender were associated with this variable. Generally, older drivers (ages 75 years and above) were more likely to have thought about this issue than younger drivers [c2 (2 df) = 44.7, p < .001], and women were more likely than men to have thought about stopping driving [c2 (1 df) = 3.9, p < .05] (64% versus 59%, respectively). Marital status and location of residence were also associated with this variable. Those who were widowed or never married were more likely to have thought about this issue than those who were married or divorced or separated [c2 (4 df) = 24.4, p < .001], and those living in metropolitan areas or in coun- try towns close to the town centre were more likely than those living in rural areas to have thought about the pos- sibility of not driving [c2 (3 df) = 13.4, p < .01]. In response to questions regarding planning ahead for not driving one day, the majority of drivers (75% of females and 82% of males) reported that they had not made any plans. Female drivers were, however, more likely to report having made some plans compared with male drivers (20% versus 15%, respectively) [c2 (2 df) = 12.2, p < .01]. Table 3 shows specific plans by gender. Of those who indicated that they had made plans for not driving one day, female drivers were more likely than male drivers to have made specific plans such as mov- ing to another house and exploring alternative transport options, including public transport. A greater proportion of male drivers reported sharing the driving compared with female drivers. Few drivers had talked with their family doctor about planning for their future without the car. While these specific questions were not asked of for- mer drivers, this group was asked to indicate whether 0 10 20 30 40 50 60 Driving the same Driving more Driving less Amount of Driving Pr op or tio n Female Male FIGURE 2 Current drivers’ level of driving compared with 5 years earlier, by gender.

69ATTITUDES TO AND MOBILITY IMPACTS OF DRIVING CESSATION they thought they had stopped driving at the right time and whether the process was gradual or sudden. Overall, the majority of former drivers (65%) reported stopping all at once, and there was some suggestion that females were more likely than males to have stopped gradually (39% versus 27%, respectively). This difference, how- ever, did not reach statistical significance. In addition, the majority of former drivers felt that they had stopped at the right time (60%), and there were no gender differ- ences in this response. A number of reasons for stopping driving were pro- vided by former drivers, including the following: hav- ing someone else to drive (41.1%); alternative transport options available (48.4%); no longer enjoyed driving (48.2%); safety reasons (46.7%); health reasons, such as vision problems and poor reaction time (38.6%); encouragement from family and friends to stop driving (28.3%); crash involvement (17.3%); high cost of run- ning a car (36.6%); nonrenewal of license (13.3%); and nonattendance at medical or license renewal (26.7%). No gender differences were found for reasons for stop- ping driving. When asked about how and by whom the decision to stop driving was made, 75% of females indicated that they made the decision themselves, compared with 60% of males. Moreover, fewer females than males reported that others made the decision for them (8% versus 25%, respectively) [c2 (3 df) = 9.04, p < .05]. Some additional analyses of the data were performed to explore associations between satisfaction with current mobility and the people involved in decisions (Figure 4) and the timing of their decision to stop driving (Figure 5). Although these associations were not statistically significant, some interesting trends emerged. For those who made the decision themselves, overall satisfaction with current mobility (somewhat to very satisfied) was approximately 80%, compared with approximately 65% satisfaction when the decision was made either by others or jointly with others. Some gender differences are evi- dent here, particularly when the decision was jointly made with others: females tended to report greater satisfaction compared with males (80% versus 50%, respectively). Similarly, among those who felt that they had stopped at the right time, overall approximately 80% reported Female Male 0 10 20 30 40 50 60 Very satisfied Somewhat satisfied Not very satisfied Don’t know Satisfaction with Current Mobility Pr op or tio n FIGURE 3 Former drivers’ satisfaction with ability to get to places, by gender. TABLE 3 Current Drivers’ Planning for Retiring from Driving Percentage of Drivers Responding Yes 95% Confidence Plan Female Male p-Value Odds Ratio Interval Moved house 38.8 22.9 <.01 0.47 0.27–0.83 Became familiar with public transport 75.7 66.4 NS Explored alternative transport 75 61.7 .07 0.59 0.34–1.04 Moved closer to family, friends, social networks 35.3 18.9 <.05 0.43 0.23–0.80 Talked to GP 16.9 9.2 NS Shared the driving 31.7 49.3 <.05 2.10 1.17–3.75 Note: NS = not significant.

70 WOmEn’S ISSUES In TRAnSpORTATIOn, vOLUmE 2 being very or somewhat satisfied with their current mobility. In contrast, for those who stopped too early or too late, reported satisfaction with current mobility was lower (for females, this was 64% and 63%, respectively, and for males, 57% and 0%, respectively). Females were generally more likely to report satisfaction as compared with males, regardless of the timing of their decision, especially those who felt that they stopped too late. diScuSSion of findingS Independent mobility is an important part of well-being for all, and car use (as a driver or passenger) is one of the major determinants of quality of life for seniors in most western countries (1, 3, 5). There has been much emphasis in transportation research over the past few decades on understanding transportation needs and the factors associated with safe driving, and many programs and initiatives have been developed to help extend safe driving. Unfortunately, much less emphasis has been directed toward assisting those who need to consider retiring from driving, and particularly toward focusing on the specific mobility needs of older female road users. This study sought to understand the processes involved in successfully maintaining mobility options in the tran- sition from driver to nondriver status. In particular, a better understanding of the effect of gender on this pro- cess was sought. The findings of this study suggest that, although many drivers are strongly interested in driving for as long as possible and have negative perceptions of the mobility consequences of this transition, those who have gone through this process generally seem to have a more posi- 0 10 20 30 40 50 60 70 Made decision myself Others made the decision Made decision along with others Decision Process Pr op or tio n Pr op or tio n 0 10 20 30 40 50 60 70 Made decision myself Others made the decision Made decision along with others Decision Process Very satisfied Somewhat satisfied Not very satisfied Don’t know (a) (b) FIGURE 4 Former drivers’ satisfaction with current mobility, by decision process: (a) females and (b) males. Very satisfied Somewhat satisfied Not very satisfied Don’t know (a) (b) 0 20 40 60 80 100 Timing of Decision Pr op or tio n 0 20 40 60 80 100 At the right time Earlier than I should Later than I should have At the right time Earlier than I should Later than I should have Timing of Decision FIGURE 5 Former drivers’ satisfaction with current mobility, by timing of decision: (a) females and (b) males.

71ATTITUDES TO AnD mOBILITY ImpACTS OF DRIvInG CESSATIOn tive attitude. moreover, the findings of this study sug- gest that two factors—making the decision themselves or jointly with friends and family and feeling that they stopped at the right time—result in greater satisfaction and quality of life. This seems to be true especially among female former drivers. In terms of driving patterns and behaviors among driv- ers, the current findings confirm those of previous stud- ies. This sample of Australian drivers was fairly mobile, driving frequently and for substantial distances, and, importantly, they reported good satisfaction with their amount of driving. As in previous studies, there were noted gender differences in travel patterns, particularly lower mileage and frequency of travel among females as compared with males, and fewer females reporting being the main driver of the household (16, 17, 20). Only a small proportion of respondents felt that they drove less than they would have liked, and they were most likely older male drivers. While former drivers’ amount of out-of-home travel was lower than that of drivers, there was still substan- tial mobility among this group, with almost two-thirds reporting that they went out at least 3 to 4 days per week, mainly as passengers. more importantly, there were no gender differences here—females were as likely to engage in out-of-home activities as men. The reduction and cessation of driving and the pro- cesses involved in this transition were the main focus of this paper; the goal was especially to understand more fully what behaviors, attitudes, and processes result in a suc- cessful transition. moreover, a greater understanding of gender differences in this transition was investigated given previous suggestions that older women modify, reduce, and voluntarily stop driving at a younger age and in better health than older men (14–17, 21, 22), and, perhaps for some, with a more negative mobility impact (23). Giving up driving evokes a level of fear among many older drivers, and there are reports of negative conse- quences of driving cessation for some, including stress and poor psychological outlook, life satisfaction, community engagement, and quality of life (5, 9, 10); an increase in depression and isolation; loss of self-confidence and status; declines in physical activity and health; and, in extreme cases, even early death (6, 24, 25). It is also possible, how- ever, that, if this transition is managed and planned well, the impact on mobility and life satisfaction may not be so severe (11, 12). The findings of this study suggest that this is the case. Current drivers generally perceived only negative impacts of driving cessation, including loss of indepen- dence, reliance on others for transportation, difficulty in using public transport, and the need to change their lifestyle to accommodate the loss of driving privileges. While a large proportion reported having thought about the possibility of not driving one day, unfortunately, the great majority indicated that they did not want to make this decision, and few had made any plans for this event. Females were more likely than their male coun- terparts to have thought about this and to have made specific plans, particularly moving and exploring alter- native transport options. Few women reported that they shared the driving, but a substantial proportion of men reported doing so. This supports previous findings that many older women lose confidence in driving and lack up-to-date driving experience as a result of their male partner undertaking most of the driving when driving together (20, 26), and it points to the need for educa- tional programs aimed at promoting increased (safe) driving among women. Encouragingly, this study’s findings also suggest that, although the anticipation of transitioning from driver to nondriver status generates a considerable level of con- cern among those still driving, this effect appears to be less evident among those who have actually taken the decision to stop driving. Among the former driver group, even though close to half said that driving was very important to them and that frequency of out-of-home activities had decreased since they stopped driving, their reported levels of satisfaction with current mobility were relatively high. Three-quarters of former drivers reported being somewhat to very satisfied with their ability to get to places. Thus, although out-of-home activities were lower among former drivers as compared with current drivers, satisfaction with mobility did not diminish as might be expected. The fears held by many current driv- ers regarding potentially poor outcomes of the transition to nondriver status may not be warranted. There were also some noted gender differences in the transition from driver to nondriver status, with associ- ated differences in satisfaction levels. males were more likely to have reported stopping driving suddenly, while females were likely to stop gradually, confirming previous findings that women are more likely to self-regulate (17, 18, 20), but also suggesting that there was some level of planning involved in this process. It will be interesting to explore this issue among former drivers in the future. Two decision-making processes were explored fur- ther in these analyses: (a) who made the decision to stop driving, and (b) the timing of that decision. Although few statistically significant findings were achieved, due to a small sample size of former drivers, some interesting trends emerged. Those who made the decision to stop driving by themselves and made it in a timely manner (i.e., who felt that they stopped driving at about the “right time”) were more likely to report higher levels of satisfaction compared with those who had the decision made for them and stopped earlier or later than they should have. Furthermore, there was some suggestion of gender differences. Overall, females were more likely to have

72 WOmEn’S ISSUES In TRAnSpORTATIOn, vOLUmE 2 made the decision on their own, while males were more likely to have had the decision made for them. Interest- ingly, the satisfaction of females who made the decision jointly with others was generally high. This was not so for males. Regarding the timing of the decision, stop- ping too late seems to have had a negative impact for males only. moreover, stopping too early did not seem to result in dissatisfaction, especially for females. This raises some questions about previous suggestions of the negative impact of premature driving cessation for some women (18). While these are only preliminary findings, and there are no doubt many contributing factors to the timing of the decision to stop driving and resulting life and mobility satisfaction, they suggest that, perhaps with good support and planning ahead, an early transition to nondriver status among women may not result in the negative consequences previously thought. This issue warrants further investigation, and with a larger sample of former drivers. These findings can play some role in guiding efforts to improve seniors’ safe mobility, with and without the car. Education and training to improve the driv- ing experiences of older drivers are central to current international thinking about this group’s safe mobility, and there is increasing recognition of the benefits of programs aimed at assisting a smooth transition from driver to nondriver status. This process needs to be man- aged well; however, understanding attitudes, behaviors, and gender differences is an essential step in develop- ing resources to assist seniors. Resources that provide appropriate gender-specific information and strategies for ways to retire from driving gracefully and informa- tion on alternative transport options can play a major role in removing some of the stress and trauma typically associated with this decision. concluSionS This study examined gender differences in the transi- tion from driver to nondriver status among a sample of Australian drivers and former drivers. The study high- lights some factors that may achieve a more acceptable and potentially less stressful transition and alleviate the consequences of poor mobility, particularly among older women. The findings of this study confirm those of previous studies that note gender differences in driving patterns and the tendency for women to reduce and cease driving earlier than men. A major contribution of this study has been the addition of some new information on gender dif- ferences in the decision-making process and the identifica- tion of some strategies and attitudes that may play a major role in reducing some of the stress, trauma, and mobility impacts generally associated with driving cessation. As implied in the findings discussed above, it is unlikely that any single factor can adequately explain the reasons for driving reduction and cessation and the attitudinal and behavioral factors that contribute to a successful transition from driver to nondriver status. While there is still much to be understood about this transition and the strategies and behaviors that can be used to achieve successful retirement from driving, the findings from this study provide some information on which to conduct further research. This study has explored some interest- ing attitudinal differences between those still driving and those who have already made the transition to nondriver status. It has added to the current understanding of the importance of how and when decisions are made in influencing seniors’ experiences and adjustments to life without driving. Further, it has identified associations between planning ahead, a good psychological outlook, and recognizing the right time for stopping driving and good life satisfaction and mobility outcomes, particu- larly for women. These findings have practical implications for both the road safety community and health-care specialists. In particular, this study identified the need for promot- ing strategies through gender-specific resources, infor- mation, and training programs to assist a smooth driver to nondriver transition. RefeRenceS 1. Organisation for Economic Co-operation and Develop- ment (OECD). Ageing and Transport: Mobility Needs and Safety Issues. 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