1. Senior Victorians and walking: Obstacles and opportunities Dr Jan Garrard Active Transport Consultant

2. Walking across the life course… “Walking is the first thing an infant wants to do and the last thing an older person wants to give up.” (International Charter for Walking, Walk 21, October 2006).

3. Summary and full report available from Victoria Walks: http://www.victoriawalks.org.au/Assets/Files/FINALSenio rsFullReport.pdf

4. Study components 1. Desktop literature review 2. Analysis of walking data (VISTA) for Victorian seniors 3. Eight focus group discussions with senior Victorians 4. Survey of senior Victorians (N = 1128)

5. This presentation  Draws on selected findings from the four study components covering:  Health and social benefits of physical activity/walking for older adults  Senior Victorians’ walking behaviour  Supports and constraints on seniors’ walking  Creating supportive environments for seniors’ walking

6. Why promote seniors’ walking? (i) Higher risk of chronic diseases associated with physical inactivity Proportions of Australians with heart disease, diabetes and cancer (Source: ABS 2012)

7. (ii) (many!) more seniors... Historical and projected age profile of the Australian population (Source: CSIRO, 2010, Global Megatrends, Australian Business Foundation Event, 21 July, 2010; based on ABS data)

8. (iii) Who are less active Physical activity levels (adequately active) by age, Victoria, 2010 (Source: Victorian Population Health Survey)

9. Never too old to be active... “Move more often every day” (British Heart Foundation 2012) Recent activity is the key Maintaining activity into older age Getting sedentary individuals active Benefits outweigh the risks

10. Walking: senior Victorians’ preferred form of physical activity (ABS 2012)

11. Walking for transport  Has all of the health benefits of moderate intensity physical activity and more: * Health, environmental, transport and community liveability benefits of reduced car use * An ‘incidental’ form of physical activity (PA) for people who might otherwise be sedentary * A more socially inclusive form of PA than leisure- time physical activity

12. Creating supportive environments for transport walking – an investment in health equity (Source: National Health Survey, ABS 103) The first quintile refers to the most disadvantaged 20% of areas in Australia, and the fifth quintile refers to the most advantaged 20% of areas in Australia based on the ABS SEIFA Index)

13. Understanding and supporting seniors’ walking Physical environment (natural and built) Policy/regulatory environment Social/cultural environment Intra-personal factors Walking for recreation and transport

14.  Focus on intra-personal factors (particularly ‘functional decline’) has detracted from other determinants of older adults’ walking, particularly environmental factors

15. Proportion of trips by walking, age 65 years and over: international comparative data

16. And within Victoria... Proportion of trips by walking for seniors and the overall adult population by metropolitan Melbourne LGA (Source: VISTA 2009-10)

17. What are the obstacles to more senior Victorians walking?

18. It’s not about attitudes “…the last thing an older person wants to give up.” (Source: Focus Group Discussions) “Basic to people – it’s not one of those superficial things.” “I can’t imagine not doing it – it’s part and parcel of my life.” “It would be terrible – stuck all day at home!” “I value my walking very much...I don’t know what I would do. 11 out of 10 – that’s how important it is!”

19. Or distances seniors are able and prepared to walk (Source: VISTA 2009-10)  Senior Victorians (60+ years) walk an average of 0.5 (walk- only) trips a day  Mean walking trip distance:  0.9km (seniors)  0.9 km (Victorians aged 20+)  Walking trip distance by age (not statistically significant):  1.0km for 60-69 years  0.9km for 70-79 years  0.7 for 80 years or over  Mean walking trip time:  13.7 minutes (seniors)  12.5 minutes (all adults aged 20 years and over)  Supportive environments for walking in general more seniors walking

20. Reasons for walking for recreation, exercise or to get to places (0 = No, not important; 1 = Yes, somewhat important; 2 = Yes, moderately important; 3 = Yes, very important) (Source: Seniors’ Walking Survey)

21. Recreational/transport walking by age (Source: Seniors walking survey)

22. Seniors’ walking destinations by age (Source: VISTA 2009-10)

23. Constraints on seniors’ walking: walking environments and the behaviour of other road/path users (Source: Seniors’ Walking Survey)

24. Factors impacting on feelings of safety while walking (Source: Seniors Walking Survey) (0 = No, wouldn’t make me feel any safer; 1 = Yes, a bit safer; 2 = Yes, moderately safer; 3 = Yes, much safer)

25. Additional walking needs for senior Victorians  Make walking:  Attractive  Interesting and attractive routes and destinations (including for utility trips)  Comfortable  Shelter (from weather, including shade), seating, public toilets  Appealing  Access to shops, services and public transport  Safe  Traffic-related injuries  Fall injuries

26. Pedestrian fatalities by age, Victoria, 2003-2012 (Source: TAC Online Crash Database 2012)

27. Are older pedestrians risky road users?

29. Risky road users? (Source: Michael Nieuwesteeg, Allison McIntyre. “Exploring the pedestrian crash problem from the perspective of injured pedestrians”. Australasian Road Safety Research, Policing and Education Conference, 31 August-3 September, 2010, Canberra) Crash type Pedestrians aged 16-39Pedestrians aged 60+ % of crashes Pedestrian crossing road71%79% Crossing intersection35%46% Crossing mid-block34%27% Crossing roundabout3%7% Pedestrian not crossing road29%21% TAC survey, pedestrians aged between 16 and 39 years (n = 110) and pedestrians aged 60 years plus (n = 90), pedestrians injured in crashes in 40, 50 and 60 km/h speed zones in Victoria in 2008.

30. Who was at fault? (younger and older age groups combined) Driver only Pedestrian only Both partiesUnclear Crossing at intersection 79%10%5%6% Crossing mid-block44%30%3%23%

31. Older pedestrians: more ‘careless’ than younger pedestrians? Issue 16-39 years 60+ years Pedestrian at fault 34%12% Heavy or congested traffic 23%10% Poor light conditions 46%26% Raining 8%11% Tired/fatigued 15%3% Stressed/anxious 14%2% Distracted 23%2% Impaired by alcohol 25%3% Impaired by drugs 0%NA Impaired mobility NA8%

32. ‘At-risk’ rather than ‘risk-taking’  Reduced motor, sensory and cognitive abilities which, together with increased frailty, can increase the risk of pedestrian injury (GOAL Consortium 2012); BUT  Older adults are more cautious and law-abiding pedestrians than younger age groups.  They are not risk-takers, but rather at-risk from the environment they move about in.  Because they are generally careful pedestrians, unexpected incidents (eg cyclists overtaking closely at high speed, unleashed dogs) cause considerable concern, though actual risk of injury is low.  Fall injuries are a greater risk for older adults than younger adults - indications from the study that fall injuries are a greater concern for older adults than traffic injury risks.

33. Fall injuries among older adults using the public road system  Less is known about the causes of fall injuries while walking in public spaces than traffic collision injuries  Probably outnumber collision injuries by at least a factor of two  ‘Trade-off’ between avoiding fall injury or traffic injury (eg gaze directed at walking surface rather than traffic when crossing roads)  Combination of individual (functional) and environmental factors:  Lack of footpaths  Poorly designed and/or maintained footpaths  Road crossings (placement, design, road user behaviours)  Shared paths (design and users – cyclists, other pedestrians, uncontrolled dogs)  Older pedestrians require a Safe System of safer roads, vehicles, speeds and road user behaviours

34. (Source: BITRE 2012; Victoria Walks - http://www.victoriawalks.org.au/) Average annual percentage change in fatalities by road user group, 2002-2011

35. Summary: Supporting older adults to do what they want to do  Many seniors want to walk, for a range of reasons, thus providing multiple motivators: Health, independence, mobility, social connectedness, community engagement  Create supportive environments: Access to shops, services and public transport via walking networks and infrastructure that are safe and perceived to be safe from traffic, falls and assault.  Variations in seniors’ walking rates by LGA in metropolitan Melbourne demonstrate that walking in local neighbourhoods will occur ‘naturally’ and ‘incidentally’ when walking is established as a feasible, appealing, attractive, convenient, safe alternative to car travel for short local trips.

36. Thank you!