Elizabeth Webb is a lecturer in gerontology at the University of Southampton, a member of the ESRC’s International Centre for Lifecourse Studies and principal investigator of an ESRC grant to investigate causes and consequences of caregiving in later life. She has an interest in older people’s physical capability and use of transport.
The National Institute for Health and Care Excellence (NICE) is consulting on new draft guidelines on environmental changes which should be made to support people to be physically active. The consultation caught my eye, since it directly relates to some ESRC funded research I recently published with colleagues.
The draft NICE guidelines state that local authorities should ensure pedestrian crossings give people with limited mobility enough time to cross the road. This is a laudable aim, however I want to emphasise that the current guidelines for crossing speeds don’t just disadvantage people who would be thought of as having limited mobility, but a large majority of the UK’s older population.
Current guidelines require pedestrians to walk at 1.2 metres/second, equivalent to 2.7 miles/hour, to cross at a pedestrian crossing. The speed is set by local authorities and aimed at reducing the risk of being hit by a motor vehicle or cyclist. Our research, which used walking speed measurements on more than 10,000 people aged 60 years and older living in England, shows that 90% of older people don’t walk fast enough to cross the road safely at a pedestrian crossing. In addition, there are substantial social inequalities in the ability to cross the road in time. At age 60, the richest people were more than five times more likely to be able to cross the road in time than the poorest, and this gap grew as people aged. This is likely to be because richer older people have had many advantages across their lifecourse which lead to better physical capability at older ages that poorer older people have not had; wealth is a useful way of measuring that advantage by proxy. But even the majority of the wealthiest and healthiest people aged 60 years and older do not walk fast enough.
The difficulty crossing the road in time could put older people at increased risk of injury through a road traffic accident. Concerns about this risk could discourage older people from walking about in their community, leading to physical inactivity and social isolation. Someone who is not confident of crossing the road safely is much more likely to get in their car than decide to walk or get the bus, either of which would have introduced physical activity into the journey. However, for the many older people, particularly women or less wealthy older people, who do not drive or own a car, even this is not a possibility and the journey may be avoided altogether.
If the new NICE guidelines are intended to encourage people to be physically active in their neighbourhoods, we suggest that they may not go far enough.
We are therefore calling on NICE to consider specifying a slower crossing time than the current 1.2m/s; a crossing speed of 0.8m/s would allow most older people to cross the road safely well into their 70s. This is not sufficient though: for people to stay physically active and healthy as they age they need to be confident of crossing the road safely into their 80s, 90s and beyond. Other researchers have suggested that extending the use of timed crossings, at which the time remaining to cross counts down, could increase the confidence of those with slower walking speeds. Even better would be if local authorities were to replicate Singapore’s policy, whereby older people and others with mobility difficulties have a pass which they can scan at crossings, which allows for extra time to cross.
The NICE consultation on physical activity and the environment guidelines will close on 2 October 2017.
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