[Negative effect of perceived transportation problems on social activities of elderly people living in a small town far from the nearest train station]

Abstract

Social activities such as visiting friends or participating in community groups have been shown to correlate positively with active health promotion, more frequent physical exercise, and maintenance of activities of daily living in older people. Social inactivity may result from personal factors such as physical condition and from environmental factors such as limited means of transportation. To study the latter factors, we focused on perceived transportation difficulties and on the influence of those perceptions on the daily activities of elderly people. We sought to test the hypothesis that perceived transportation problems restrict health promotion or social activities and accelerate the decline in activities of daily living, and also to determine how transportation can be improved. A questionnaire was sent to 238 people (a fifth of the population) aged 60 years or older who were living in a small town in Kanagawa prefecture. Buses are the principal mode of public transportation from their residences to the nearest train station and the trip takes about 50 minutes. Responses were received from 190 persons (83.3%, excluding those who had died, moved, or were in the hospital). Of the respondents, 166 (74 men and 92 women) went out by themselves and their responses were subjected to logistic regression analysis. The results revealed the following points. (1) For both men and women, riding buses to the hospital was associated with a greater perception of problems with respect to convenience, physical exertion, or anxiety when crossing the road. (2) Among women, greater perceived inconvenience of transportation correlated with a lower frequency of going out for daily shopping; a higher frequency of visiting friends correlated with greater perception of physical exertion. (3) Among women, the main desire was to visit friends. Men indicated that they wanted to be more active in hobbies. The women indicated that the main reason they do not fulfill their desires was that transportation is inconvenient. These findings indicate that perceived transportation problems can prevent elderly people, especially women, from going out for health promotion and social activities. This indicates that to support social activities of elderly people, the means of transportation should be made more convenient and more physically accessible, and local circumstances should be taken into consideration.