The Social and Policy Predictors of Driving Mobility Among Older Adults

This research was designed to identify the impact of state driver's license renewal requirements on the driving mobility (i.e., the reduction or cessation of driving) of older (70 years or older) drivers in the United States. Nationally representative data from four waves (1993–2000) of the Asset and Health Dynamics of the Oldest Old study were linked to state policies on relicensing and used in a longitudinal logistic regression analysis. The author assessed the driving behaviors of a sample of 9,638 men and women. The findings demonstrate that the driving mobility of older people is influenced by state relicensing policies. The analysis indicates that five policies—accelerated renewal, mental testing, peripheral vision testing, renewal in person at age 70+ (as opposed to renewal by mail or online), and restricted licensing—have a significant effect on an older driver's decision to reduce or cease driving. The driving patterns of older adults are influenced not only by their health and socioeconomic backgrounds, but also by state relicensing policies. In terms of public policy, this result shows that there is a mechanism for extending the years of independent mobility for older people: restricted licensing.     

Informal Caregiving for Elders in Sweden: An Analysis of Current Policy Developments

The purpose of this study was to conduct a systematic review of the literature related to state policies concerning older drivers and to draw policy conclusions about which policies appear to work to reduce older driver crashes and to identify areas needed for further research. Specific policies examined in this paper concern medical reporting and medical review, license renewal processes, and driver testing. A study was included in the systematic review if it met the following criteria: published in English between 1991and January 2013; included data on human subjects aged 65 and older residing in the United States; included information on at least one policy related to older drivers; and had a transportation-related outcome variable (e.g., crash, fatality, renewal). A total of 29 studies met inclusion criteria. Twenty-two studies investigated license renewal and seven articles examined medical reporting. In-person license renewal requirements were associated with reduced risk for fatal crashes. Restricted licenses were associated with reduced number of miles driven per week. More intensive renewal requirements and being the subject of a medical report to the licensing authority was associated with delicensure. Given the importance of driving to mobility, quality of life, and public safety, more research is needed.     

Gambling on the Lottery: Sociodemographic Correlates Across the Lifespan

Two representative U.S. telephone surveys of gambling were conducted—an adult survey of adults aged 18 years and older (n = 2,631) and a youth survey of young people aged 14–21 years old (n = 2,274). Because the questions and methods were the same or similar in both surveys, the data from these two surveys were combined into a single dataset to examine the prevalence and sociodemographic correlates of gambling and problem gambling across the lifespan. The present work focused specifically on gambling on the lottery which is the most prevalent form of gambling in the U.S. The frequency of gambling on the lottery increased sharply from mid adolescence to age 18 which is the legal age to purchase lottery tickets in most states; lottery play continued to increase into the thirties when it leveled off and remained high through the sixties and then decreased among those 70 years and older. Considering multiple sociodemographic factors together in a negative binomial regression, the average number of days of lottery gambling was significantly predicted by male gender, age, neighborhood disadvantage and whether or not lottery was legal in the state where the respondent lived. These findings can be used to inform policies regarding lotteries in the U.S.     

Motives for and barriers to physical activity among older adults with mobility limitations

The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N=645) age 75-81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility limitation emphasized health promotion and positive experiences related to exercise. Information about differences in motives for and barriers to exercise among people with and without mobility limitation helps tailor support systems that support engagement in physical activity among older adults.     

Policies for older volunteers: A study of Germany and Italy, 1990–2008

Older people increase their well-being and contribute to the community when they volunteer. Therefore, policy-makers sometimes consider supporting older volunteers. However, they reach different conclusions on whether they should introduce policies for older volunteers, and on what policy would be the most suitable. This article studies how policies for older volunteers emerged in Germany and Italy, both countries having one of the oldest populations in the world. It explores the political discourse on older volunteers, and how this discourse translates into policies. To do this, the article presents data collected in expert interviews and document analysis. Findings show that German policy-makers stress the contribution of volunteering to older people's well-being and have introduced policies for older volunteers. Italian policy-makers, in contrast, frame older volunteers as social service providers and have decided not to single out specific age groups in their policies for volunteers. Moreover, the policies are influenced by the policy-makers' perceptions and path-dependencies, meaning policies and institutions that were introduced in the past. These findings suggest that whether or not policies for older volunteers emerge depends less on the characteristics of the older population and more on the society and its political traditions.     

The potential role of physical activity on driving performance and safety among older adults

The elderly represent the fastest growing driving population. Older drivers have a high crash rate per distance traveled, a high risk of injury or death in traffic accidents, and are commonly found to be ‘at fault’ in crashes. This reality has focused more interest on issues associated with the fitness to drive and the safety of older drivers. Many older adults depend greatly on their personal vehicle for transportation and suffer a marked loss of quality of life when, as a consequence of no longer being able or permitted to drive, their mobility becomes significantly restricted. The reasons for the deterioration of driving performance that occur during the aging process are multi-factorial and a great deal of research has focused on the identification of those factors. Nevertheless, some studies incorporating training programs have tried, with some success, to improve the driving-related abilities of older drivers. It has been demonstrated that physical activity can promote several skills that are associated with driving performance in older drivers. Few studies, though, have conducted exercise interventions among older drivers intended to enhance their driving-related abilities and promote road safety. In this context, the purpose of this work consists of examining the perceptual, cognitive, health, and physical factors related to fitness to drive in older adults and identifying possible strategies that can enhance their driving-related abilities. Moreover, potential mechanisms underlying the relationship among physical activity, driving ability, and road safety are discussed.     

Transnational habitus at the time of retirement

ABSTRACT

International mobility requires the shifting of bodies across places, through life courses and stages, creating individual and collective experiences that become taken for granted. They are habitus, which is the durable deployment of an individual’s body in the world, as well as a scheme of perception, thought and action that is present throughout life, including retirement. This study asks what kind of transnational habitus is visible in the narratives of interviewed older adults at the time of retirement. The answer is sought by analysing life stories of mobility from older adults who live or have lived abroad for several years. The multilocal transnational habitus of interviewees rests on their desire to maintain their mobility when retired. However, both their physical and mental international mobility are at risk when faced with an ailing body and mind, and policies allow and restrict the transferability of benefits and accessibility to services.     

Housing Canada's Oldest-Old: Correlates of Their Residential Status

ABSTRACT

The authors examined determinants that contribute to keeping Canada's oldest-old (those 85 years and older) living in their own homes by focusing on determinants associated with living in certain types of homes. Multivariate logistic regression was done on a sample of 722 community dwellers aged 85 years and older from the 2001 Participation and Activity Limitation Survey. It was found that gender, marital status, and financial status determine residential status of the oldest-old and that high and low levels of mobility and instrumental activities of daily living foster community living. Previous findings suggest a trajectory of social exclusion (from house to apartment to facility). The current study shows the oldest old as socially stable, living in their homes. New policies to support their residential status and modifications to old policies are critical.     

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.     

Alternative strategies for redistribution in urban renewal

The theme of this congress is the redistribution of available resources to improve urban living conditions for the underprivileged and so provide more equal opportunities in urban life. In the past, much of the resources for redistribution were made available through growth in the economy. Currently, however strong the policies, this kind of redistribution has become more difficult as the developed world has moved from economic growth to economic stagnation, resulting in fewer resources available in the public or private sectors for redistribution. These difficulties are exacerbated when particular countries adopt vigorous restrictions of the money supply, monetarism, to pursue economic goals, such as combatting inflation, which of itself damps down rather than stimulates growth.How then is the redistribution of resources to be pursued in order to advance urban living conditions for the underprivileged? The answer to this question starts from the recognition of the obvious: that distribution of product (from any activity) is a consequence not only of “how much’ but also of how the resources for the activity are in fact employed. Using a national contractor with mobile labour for new house building will result in a different distribution from using local people with local materials.Similarly, there are many different approaches to tackling urban and community renewal, as is clear from a review of practice around the world since World War I. This paper will be looking for a pattern in the variety of approaches, and for a possible trend in the changes that have taken place in such approaches over the past 30 years.These changes have been put into a sharp focus in one small country (Israel) through the national programme of Project Renewal, which has been described in another paper in this congress.¹ Here it will be argued that the Israeli programme had telescoped into 3 years a sequence of change which has been evolving for the past 30 years in USA, the UK and other countries in Europe.This paper will indicate one approach which seems to be emerging from that process of change and which was employed in the town of Ashkelon in Israel. It is based on the better utilisation at the local level for the underprivileged of such resources that are available. Better utilisation is not regarded simply as deriving from a more efficient use of such resources through the use of economic calculus by central administration but rather through the involvement of the local community and individuals in a similar process to that which takes place where adaptation and mobility are self-generated.That is not to say that government resources become altogether unnecessary. But, instead of using them to top up the ever present shortfalls, they are used as a catalyst to introduce regeneration.Thus we believe a more effective redistribution of benefits can be achieved even with a lesser allocation of resources, provided they are properly used.But the approach in Ashkelon of itself is not the important question for this Conference. It is rather: has the approach a more general application, as a way of tackling renewal and a strategy for redistribution?My conclusion on this question is presented in the second part of the paper which provides a tentative overview of what has been happening in urban renewal since World War II in Europe and the USA. There I show the changing focus of renewal by reference to five strands which are found to a greater or lesser extent in any renewal programme: the physical, social and economic content of the programme, and the political and public participation driving forces behind them. From this tentative overview come two tentative conclusions: that the varying approaches in Israel to renewal in the past 3 years have reflected the variety in approaches over the past 30 years in the USA and UK, and that the trend in these approaches does encourage the notion that the Ashkelon approach has wider relevance as a model for regeneration strategies.The review of changing approaches to renewal suggests that regeneration is not simply a response to the current economic situation in the western world, but a culmination of a long standing trend, and one that should be used even at times of economic prosperity.     

Local and Regional Governments and Age-Friendly Communities: A Case Study of the San Francisco Bay Area

The purpose of this study was to assess the extent to which cities, county departments of adult and aging services, county transportation authorities, and public transit agencies in the San Francisco Bay Area have in place age-friendly policies, programs, and infrastructure in the areas of community design, housing, transportation, health care and supportive services, and opportunities for community engagement. The most common age-friendly features include those that target alternative forms of mobility (for example, incentives for mixed-use neighborhoods and changes to improve the accessibility of public transit), while the least common policies and programs are those that aim to help older adults continue driving, such as driver education programs, driver assessment programs, and slow-moving vehicle ordinances. The article concludes with policy and research implications of these findings.     

National policy approaches to social care for elderly people in the United Kingdom and Singapore 1945-2002

The authors compare policy approaches in the United Kingdom and Singapore on social care for older persons. The context of these approaches is discussed showing the development of policies, in each country from the aftermath of the Second World War to the present. Given that Singapore is a former British colony, it is of interest to scholars of social policy to examine its welfare approach as compared to the welfare state approach espoused by the United Kingdom. Both nations are faced with the challenges of an aging population, which necessitates handling similar problems with strategies that are in harmony with their respective economic, social, and cultural contexts. This paper considers their divergence of philosophies and policies, concluding with the recognition that the major difference lies in national and governmental expectations regarding the extent of the financial and regulatory responsibility for care for older people carried by the individual, the family, and the state.     

Using naturalistic driving films as a design tool for investigating driver requirements in HMI design for ADAS

In recent years, there are many naturalistic driving projects have been conducted, such as the 100-Car Project (Naturalistic Driving study in United State), EuroFOT(European Large-Scale Field Operational Tests on Vehicle Systems), SeMi- FOT(Sweden Michigan Naturalistic Field Operational Test and etc. However, those valuable naturalistic driving data hasn't been applied into Human-machine Interaction (HMI) design for Advanced Driver Assistance Systems (ADAS), a good HMI design for ADAS requires a deep understanding of drive environment and the interactions between the driving car and other road users in different situations. The results demonstrated the benefits of using naturalistic driving films as a mean for enhancing focus group discussion for better understanding driver's needs and traffic environment constraints. It provided an efficient tool for designers to have inside knowledge about drive and the needs for information presentation; The recommendations for how to apply this method is discussed in the paper.     

“STREETVILLE FOREVER”: ETHNICITY,COLLECTIVE ACTION,AND THE STATE

Contemporary state policies in European and American societies mark a shift from older forms of governance focussed on the centrally concentrated state toward strategies that aim to limit governmental intervention by getting people to govern themselves. This means that individuals and communities are charged with carrying out roles and functions that were traditionally performed by the state. In this article I examine the conditions in which local people in an urban neighbourhood in the United Kingdom who were the objects of this new mode of governance came to negotiate and resist its policies and structures. Residents and community workers came together in opposition to the local Council to make demands that they considered to be of interest to the members of their neighbourhood across ethnic, racial, gender, and class boundaries. In so doing they crafted a multiracial neighbourhood identity that was more inclusive than the categories deployed by the state. This examination of collective initiatives that resist and challenge the state's strategies for local governance illuminates some of the complexities, contradictions, and limits of the contemporary state.     

Are elderly men worried about crime?

It has been well documented that older adults, especially women, are more inclined to express fear of crime, but their risk of victimization is significantly lower than for people from other age groups. Even if gender issues related to fear are known, fear of crime among men is undocumented. This article explores how worry about victimization among older men (N = 156), from 3 francophone cities in Quebec, Canada, is influenced by age groups (60–69, 70–79 and 80 years old and over), health, depression, social support and prior victimization. There are significant results associated with the 3 dimensions of worry about crime (emotional, behavioural and cognitive). We conclude by commenting on the following question: Is worry about crime among elderly men a reality?     

A case study on the perception of aging and participation in physical activities of older Chinese immigrants in Australia

This qualitative study explores how older Hong Kong ChineseAustralians perceive aging and to what extent this perception affects their participation in physical activities. The main methods used were in-depth interviews with 22 participants ranging in age from 60 to 91 years. Interviews were translated from Chinese (Cantonese) and transcribed into English. Content analysis was used to find recurring themes from the interview data. The main findings indicate that the perception of aging is to some extent influenced by culture. Some participants defined aging as being measured in years, and others defined it by the state of one's physical health, appearance, and capacity to continue fulfilling one's social roles. These perceptions strongly influenced their preferences for and participation in physical activities. Acknowledging the fact that Chinese-speaking people are not culturally homogeneous, this article makes some recommendations to health service providers with regard to the development of appropriate physical activity programs.     

The Physical Housing Environment and Subjective Well-Being Among Older People Using Long-Term Care Services in Japan

Abstract

For older people using long-term care services, the conditions of their life-space may be critical. The relationships between the physical housing environment and aspects of health were examined among older people in Japan (aged 65+ years, N?=?1,928) by multivariable logistic regression analysis, adjusting for sociodemographic characteristics. Lack of safety, low access to emergency assistance, low or high indoor temperature, poor sanitary conditions, and state of home disrepair were significantly associated with negative aspects of health among people with low activities of daily living (ADL) independence. Home care service providers and policymakers need to consider the importance of appropriate environmental conditions for the most vulnerable groups.     

Preferences for redistribution: an empirical analysis over 33 countries

People’s preferences for state intervention in social policies vary. A cross-section analysis on individual-level survey data is conducted here over 33 democracies to highlight the link between the economic position of agents and their specific demand for redistribution. Controlling for a number of factors usually found to affect individual preferences in the literature, this article focuses on the role played by the occupational status of individuals in shaping their preferences. Individual labour market position, as well as family income, is shown to outweigh all other factors shaping preferences for redistribution. The odds of a manager to oppose redistributive policies are increased by 40%, as compared to those of an office clerk, for instance. Moreover, individuals’ perception of personal mobility plays an important role: the odds of holding more positive attitudes towards redistribution are up by 32% for people who think they experienced a downward mobility within the last ten years. Evidence is also found for the fact that the political regime may have a long lasting effect on collective preferences: living in former-East Germany doubles the odds of holding positive attitudes towards redistribution, as compared to living in West Germany. Finally, the research presented here identifies which socio-political groups may be formed on the basis of their preferences for redistribution.     

Mental Imagery and Production of Hand Gestures While Speaking in Younger and Older Adults

Speech and conversational hand gestures were recorded during interviews of 23 younger (M = 21 years) and 19 older adults (M = 70 years). Three kinds of questions were used in order to activate either visual images, motor images, or no mental image (abstract topics). On average, the rate of gesture production did not differ in younger and older adults, but it was significantly influenced by imagery conditions. Gesture production was higher in the motor than in the visual imagery condition, and lowest in the abstract condition. A significant interaction between age and imagery conditions influenced the proportion of representational gestures, which were relatively less frequent in older adults, especially in the visual imagery condition. Content analysis of verbal responses showed that imagery values did not differ in younger and older adults, but that concrete words were less frequent in responses to abstract questions than in the two other conditions. The implications of these results concerning the mechanisms of gesture production and the age-related changes in conversational behavior are discussed.     

Regulating older drivers: how are the states coping?

The nation's population is growing older and its dependence upon the automobile for mobility has never been higher. Traffic safety data indicate that older operators have more fatal crashes than other age groups. As more people approach their senior years the safety issues surrounding older drivers will become even more important. Findings from a 1995 survey are reported identifying the practices of states and the perceptions of licensing officials concerning the older driver issue. The results indicate a diversity in approaches and a series of institutional and behavioral conflicts in the older driver policy subsystem that contribute to imperfect licensing controls.