Walking the Tightrope: Developing a Systems Approach to Balance Safety and Mobility for an Aging Society

In an aging population, safety and mobility are often viewed as being in conflict, when in fact they are two values that must be reflected equally in transportation policy. The challenge for policy makers and for society is to emphasize and optimize both. To achieve this, a comprehensive systems approach to driver health, personal decision-making and planning, community and transportation systems construction, vehicle design, and licensing regulations is needed. Such an approach requires crafting policies based on conceptualizing the issue as a continuum of resources facilitating safety and mobility regardless of driving status. The discussion that follows reviews components of the issue and suggestions for developing a comprehensive approach.     

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.     

Environmental and policy change to support healthy aging

Given the growing evidence of the influence of the environment on older adult health, the need to design and implement effective environmental policy around healthy and vital aging is urgent. This article describes issues amenable to improvement through policy change, evidence supporting specific policy approaches and outcomes, and promising strategies for implementing those approaches. Key areas of focus are neighborhood design and safety, housing, transportation, and mobility. Strategies to build capacity for policy change are also addressed. Our goals are to foster greater attention to environmental change in support of healthy aging and to illuminate directions for policy change.     

Environmental and Policy Change to Support Healthy Aging

Given the growing evidence of the influence of the environment on older adult health, the need to design and implement effective environmental policy around healthy and vital aging is urgent. This article describes issues amenable to improvement through policy change, evidence supporting specific policy approaches and outcomes, and promising strategies for implementing those approaches. Key areas of focus are neighborhood design and safety, housing, transportation, and mobility. Strategies to build capacity for policy change are also addressed. Our goals are to foster greater attention to environmental change in support of healthy aging and to illuminate directions for policy change.     

Valuation of road safety effects in cost–benefit analysis

Cost–benefit analysis is a common method for evaluating the social economic impact of transport projects, and in many of these projects the saving of human lives is an issue. This implies, within the framework of cost–benefit analysis, that a monetary value should be attached to saving human lives. This paper discusses the ‘Value of a Statistical Life’ (VoSL), a concept that is often used for monetising safety effects, in the context of road safety. Firstly, the concept of ‘willingness to pay’ for road safety and its relation to the VoSL are explained. The VoSL approach will be compared to other approaches to monetise safety effects, in particular the human capital approach and ‘quality adjusted life years’. Secondly, methods to estimate the VoSL and their applicability to road safety will be discussed. Thirdly, the paper reviews the VoSL estimates that have been found in scientific research and compares them with the values that are used in policy evaluations. Finally, a VoSL study in the Netherlands will be presented as a case study, and its applicability in policy evaluation will be illustrated.     

Resolving mobility constraints impeding rural seniors' access to regionalized services

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.     

The discourse and dimensions of irregularity in post-apartheid South Africa

South Africa's migration policy since 1994 has been described as contradictory and confused. Indeed, there are profound differences of opinion within government and civil society over the best means to deal with what is believed to be a massive and threatening increase in clandestine migration and irregular employment.
Clarity of thought and policy debate has been hampered by an inflammatory discourse which fixates on the issue of numbers, and views all migrants as a problem and threat. Partly this reflects fundamental inadequacies in systems of data collection and analysis, and partly a poor understanding of the causes and character of cross-border migration in Southern Africa.
As a corrective, this article presents an overview of the causes and spatial/sectoral distribution of irregular employment in post-apartheid South Africa, drawing on recent research. It then critically examines efforts to ascertain the dimensions of undocumented migration to South Africa, concluding that the results are fundamentally flawed by the methodologies used. The article then disaggregates irregular migration and assesses current knowledge about each subcategory.
In conclusion, the article argues for a comprehensive labour market survey as the foundation for a coordinated and rational approach to the challenges of irregular migration and employment.     

Decentralization, aging policy, and the age of Clinton

This article examines the recent trends in decentralization and their implications for aging policy in the Clinton presidency. It first discusses a decade-long trend toward decentralizing policy and then examines some recent federal enactments that promote more discretion by state and local policymakers, suggesting that these may set the framework for aging policy during most of Clinton's first term. A basic premise of the discussion is, however, that the degree of flexibility varies with the policy area being analyzed-housing, transportation, health and social services--and whether these are "old" (pre-1980s) or "new" (post-1980s) policies. It concludes with the suggestion that a dual-centered, shared federal-state solution may provide the best approach to the premier issue in aging policy today-long-term care.     

Anthropological Takes on (Im)Mobility

In this introduction, we outline the general conceptual framework that ties the various contributions to this special issue together. We argue for the importance of anthropology to “take on” mobility and discuss the advantages of the ethnographic approach in doing so. What is the analytical purchase of mobility as one of the root metaphors in contemporary anthropological theorizing? What are the (dis)advantages of looking at the current human condition through the lens of mobility? There is a great risk that the fast-growing field of mobility studies neglects different interpretations of what is going on, or that only patterns that fit the mobilities paradigm will be considered, or that only extremes of (hyper)mobility or (im)mobility will be given attention. The ethnographic sensibilities of fieldworkers who learn about mobility while studying other processes and issues, and who can situate movement in the multiple contexts between which people move, can both extend the utility of the mobilities approach, and insist on attention to other dynamics that might not be considered if the focus is first and last on (im)mobility as such. In this special issue, we do not want to discuss human mobility as a brute fact but rather analyze how mobilities, as sociocultural constructs, are experienced and imagined.     

Mexican Workers and U.S. Agriculture: The Revolving Door

Western U.S. agriculture is an industry that has shaped and been shaped by a peculiar labor policy: seasonal workers were outsiders who looked to agriculture for jobs, not careers. They did not plan to remain farm workers, and the industry and community in which they worked and lived did not see them as long‐term settlers. The immigration and integration policy, in effect, was to recruit new workers willing to accommodate themselves to seasonal employment, and to avoid their integration in agricultural areas. Thus, for most immigrant workers, economic mobility required geographic mobility. However, the major policy issue is not how to enhance the upward mobility of immigrant farm workers and their children; it is how U.S. agriculture should gain access to immigrant farm workers.     

From the "terrain" to "territory": which contributions from mobility and bus drivers' activity towards local development?

The focus of the present analysis is on the work of drivers in the public road passenger transportation sector in Portugal and on its specific contribution to local development. This approach dissociates itself from the one that places mobility as a "paradigm" of the contemporary societies and considers that the increase in mobility registered in the latter years is, in itself, revealing of development. For field work, a public transportation line, in an urban context, and a network of lines, in a rural context were chosen. In each of these contexts, the drivers' work was analyzed in real situations and semi-structured interviews were held with 16 of them: ten drivers in an urban context and six in a rural context. Considering the point of view of the work activity, enabled us to abandon the dominant perspectives that tend to highlight the social inequality of the mobility conditions (between those who use a private vehicle and those who need to use public transportation), to reflect on the characteristics of the mobility spaces which benefit or limit it, contributing to other inequalities. What is the importance of the space for mobility besides its support? How is it considered in the drivers' work?     

Making Movements Possible: Transportation Workers and Mobility in West Africa

This article concerns the social process of mobility control in four West African countries: Burkina Faso, Côte d’Ivoire, Mali, and Ghana. Migration has long been an important aspect of West African social, cultural, and political life. This study explores everyday enforcement of international and internal mobility control, and the ways in which Africans respond to and resist the actions of security agents. I accomplish this using ethnographic evidence gathered when travelling over 10,000 miles in Burkina Faso, Mali, Ghana, and Côte d’Ivoire over a period of nine months. In addition, data were gathered through participant observation while crossing international borders 23 times in a sub‐region of West Africa, and participating in 169 security control checkpoints in total. This evidence is supplemented by 29 interviews with transportation workers across the four countries studied. Augmenting the traditional social science literature on migrant networks with an approach proposed by development economists, this article shows that transportation workers play an essential role in mobility control in West Africa. The theoretical insights derived here contribute to a larger project of bringing borders and transportation into the same frame of reference as migration in academic study. This project sees movement through interaction, rather than simply through the systems approach so commonly applied in the literature and shows that in the countries under study there exist unstated, implicit social norms among transportation workers, their clients, and security agents, which constitute a key mechanism for migration. These actors operate in a series of structured relationships, which can be described as institutionalised, and which create a series of important exchanges governing movement in the sub‐ region.     

Deinstitutionalization: a public policy perspective

1. Deinstitutionalization was initiated in an era of social reform to protect the rights of the mentally ill; however, a strong research base was absent and led to major flaws in the policy's implementation. 2. The chronically mentally ill are frequently poor advocates for themselves and, without even the most simple needs fulfilled, end up homeless. 3. The homeless mentally ill require comprehensive support systems with assured continuity of care. An emerging concept to deal with this issue is that of case management. 4. The mental health professional can strive to influence future public policy as patient advocate and nonpartisan educator.     

Resolving Mobility Constraints Impeding Rural Seniors' Access to Regionalized Services

Rural and small town places in developed economies are aging. While attention has been paid to the local transportation needs of rural seniors, fewer researchers have explored their regional transportation needs. This is important given policies that have reduced and regionalized many services and supports. This article explores mobility constraints impeding rural seniors' access to regionalized services using the example of northern British Columbia. Drawing upon several qualitative studies, we explore geographical, maintenance, organizational, communication, human resources, infrastructure, and financial constraints that affect seniors' regional mobility. Our findings indicate that greater coordination across multiple government agencies and jurisdictions is needed and more supportive policies and resources must be in place to facilitate a comprehensive regional transportation strategy. In addition to discussing the complexities of these geographies, the article identifies innovative solutions that have been deployed in northern British Columbia to support an aging population. This research provides a foundation for developing a comprehensive understanding of the key issues that need to be addressed to inform strategic investments in infrastructure and programs that support the regional mobility and, hence, healthy aging of rural seniors.     

Policy options: early intervention services for substance-exposed infants.

Substance-exposed infants, or babies that have been victims of their mothers' drug use during pregnancy, have reached substantial proportions. Currently, no comprehensive public policy exists to deal with these infants as they enter a society unprepared to respond to an issue increasingly fraught with substantial adverse economic, social, and political ramifications. In order to address the needs of this emerging sub-population, California's governor and state legislature must develop and adopt a concerted interagency policy which outlines: a) uniform criteria for local health care workers, social service agencies, and educators; b) consistent guidelines governing the exchange of information among a range of agencies, including hospitals, schools, and other public and private agencies; and c) increased prevention and early intervention services for these babies and their families. Addressing the needs of these infants requires a bold, comprehensive, interdisciplinary approach from the creators of public policy.     

Has immobility been left behind in migration regulatory infrastructures?

The article brings the concept of the immobile left-behind population into the migration infrastructure debates focusing on countries of migrants' origin. Drawing on an analysis of government's migration policy in Kyrgyzstan and interviews with stakeholders in rural areas, the article concludes that the government relies on a traditional sectoral approach and agriculture in this regard and stands separately from mobility contexts. The policy discourse around outgoing migration focuses on mobility but less engages with return migration and the situation with left behind. We show how remittances-dependant country keeps migration policy as a non-active management tool. A starting point for a more holistic policy approach that includes the left-behind population would be facilitating discussion of left-behind needs in regions with active outmigration, including a wide range of stakeholders from migrants, family members, local authorities and migrant organizations. That would require essential changes in how policies are formulated and implemented, including introducing a cross-cutting and multi-level governance approach.     

Building an Integrated Research/Policy Planning Age-Friendly Agenda

This article describes an innovative model for integrating research into a policy and planning agenda aimed to help neighborhoods become more supportive of older adults. Philadelphia Corporation for Aging (PCA) established Age-Friendly Philadelphia (AFP) to catalyze efforts to improve the physical and social environments for seniors. The Research Program at PCA became an important part of this effort by providing multiple types of supports to PCA staff and other stakeholders. Most notably, the research program worked with planners to adopt the United States Environmental Protection Agency's Aging Initiative model for Philadelphia. That model focuses on (1) staying active, connected, and engaged; (2) development and housing; (3) transportation and mobility; and (4) staying healthy. Examples of practice efforts actualized using this research are also presented. By developing a new approach to the way research can support practice initiatives, AFP has been able to increase its effectiveness, and researchers have found better ways to work collaboratively with professionals in policy, planning, and practice. The PCA model should be considered as a framework for similar efforts aimed at creating age-friendly communities.     

Life-Stage and Mobility: An Exploratory GPS Study of Mobility in Multigenerational Families,Ahmedabad, India

As the population of older adults in India grows, research is needed to plan a sustainable future for India’s older adults. This article reports results from a Global Positioning System (GPS)–based pilot study that examined the mobility of middle-class, older adults living in Ahmedabad, Gujarat, India. Using mobility as a lens through which to examine the lives of older adults, we map potential research and identify policy areas of interest considering older adults in urban India. The study explores the role of life stage in mobility as well as the effects of gender and urban environment on mobility. Using this distinctive perspective on day-to-day life, we propose themes through which, using policy and planning tools, the living environments of older adults in Indian cities can be improved. These policy measures include focusing on walkability and pedestrian safety in residential areas and building on existing mixed land use to create high accessibility to goods and services in urban environments.     

Family homelessness in Britain: More than just a housing issue

This article offers an analysis of family homelessness in Britain and makes suggestions for change and development in both policy and practice. In Britain, family homelessness too often has been defined solely as a housing issue. The author asserts that this approach ignores the evidence that it is a complex problem in which not only economic and political, but also personal and social, factors play significant roles. The widespread failure to recognize the broad range of needs and problems experienced by homeless families seriously limits British vision and creativity in developing potential solutions. The article sets forth a number of policy recommendations, including developing comprehensive housing and service programs for homeless families; adding an intensive service component to existing homeless-at-home programs; emphasizing homelessness prevention; better utilizing persistently vacant housing; better utilizing the private rental sector; and exchanging Britain's present national commitment to temporary accommodation for an ongoing commitment to build sufficient affordable housing. These recommendations are based on the author's experience as an Atlantic Fellow in Public Policy at the Department of Social Policy and Social Work at the University of Oxford and on her 10 years of work with homeless families in the United States.     

Transportation and homelessness: a systematic review

ABSTRACT

Transportation disadvantage can negatively impact access to employment and educational opportunities, healthcare, and social services. Cost of transportation, in particular, has been found to prevent individuals’ upward mobility out of homelessness. Given the vulnerability of persons of color and those living below the poverty line and the negative implications of transportation disadvantage, the author undertook the current study to assess the extent to which scholars are analyzing transportation and its impact on adults experiencing homelessness. An exhaustive search yielded 3102 potentially relevant studies. Thirteen of these studies met the inclusion criteria for further analyses. A priori inclusion criteria included studies: (1) published between 1997 and December 2017 in refereed academic journals; (2) published in English; (3) sampling a population of adults who self-identify as currently or formerly homeless; (4) conducted using empirical quantitative or mixed methods (excluding purely qualitative, theoretical and policy analyses), and; (5) which analyzed transportation as a primary variable of interest. Findings of this research demonstrate that transportation is a critical, although under-researched, variable in the lives of individuals experiencing homelessness. Homelessness service providers, therefore, should work to shift the conversation from transportation as a privilege to transportation equity for all.