The Influence of the Built Environment on the Driving Behaviors and Mental Health of Older Adults.

Abstract

Due to increases in life expectancy, the aging of the baby boom generation, and a decline in birth rates, the US population is aging rapidly. In the future, older people will not only comprise a larger proportion of the general population, but also the driving population. This issue is characterized by a conflict between roadway safety for those who can no longer safely drive, and loss of independence when driving reduction and cessation become necessary. Previous research on driving decision making among older adults has largely focused on individual- and interpersonal-level factors. This study examined the influence of the physical transportation environment on driving reduction and cessation, after controlling for the effects of other predictors. Differences by gender and race were also assessed, as was the influence of the transportation environment on depressive symptoms. Longitudinal survival analysis techniques and generalized estimating equations were used to analyze seven waves of data spanning a 12-year period from 1998 through 2010. Results showed that after controlling for the effects of demographics, health, and social support, there was a significant influence of the transportation environment on both driving reduction and driving cessation. As roadway density and congestion increased, the odds of driving reduction and cessation also increased. Men were more affected than women by the transportation environment, and Whites and Hispanics were more affected than African Americans and those of Other race. Driving reduction, driving cessation, and the transportation environment also significantly predicted the rate of depressive symptoms over time. Depressive symptoms were positively associated with driving limitations, while a more congested environment predicted fewer depressive symptoms. Other predictors of driving reduction and cessation included relationship status, household size, and having a friend who lives nearby. Results suggest that policy changes and modifications to the physical environment should be made to improve older drivers' ability to remain engaged in life. Creating mixed-use livable communities with goods and services in close proximity are warranted to mitigate some of the mobility challenges of older adulthood. Older individuals should also consider and plan for how their transportation environment will affect their desire to age in place.PhDHealth Behavior and Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/113589/1/jviv_1.pd