We know from research—and from personal experience with our own elders—that mobility and independence are key components of mental and emotional wellness for the over 65, or senior, population. However, once they’re no longer able to drive their cars due to health and safety concerns, that mobility—or ease of getting from point A to point B—plummets. A senior who no longer drives may be supported by their family for essential trips to health care services and the grocery story, but even in this best-case scenario, their physical world shrinks substantially.

The challenge is that when the elderly stop driving, they are largely left without good alternatives for transportation. For the vast majority of seniors who live in suburban and rural areas, there is no public transit to speak of, and a car-oriented streetscape means that walking isn’t a viable option either. And for the tiny percentage living in dense cities, public transit can be challenging to navigate for seniors who spent most of their lives driving their own cars –and it may not even serve the destinations they’re hoping to reach.

The elderly community is a treasured and crucial part of our social fabric; seniors work, provide childcare to working families, volunteer, create art, and more. Improving transit and transportation systems to serve their needs is imperative, particularly as the share of the US population over the age of 65 grows.

In the latest episode in our series on demographic shifts, Talk Policy To Me reporter Reem Rayef (MPP/MA-ERG ‘21) speaks with Clarrissa Cabansagan of TransForm and Dr. Sandi Rosenbloom of UT Austin to uncover how transportation systems must respond to the existing (and growing) issue of elderly mobility –and how doing so could help get us all out of our cars and onto public transit.

Clarrissa Cabansaganis the New Mobility Policy Director at TransForm and a UC Berkeley alum. Her work at TransForm centers on transportation equity and justice, and what that looks like in the era of scooters and Uber. She is a lifetime Bay Area resident.

Dr. Sandi Rosenbloomis a Professor of Community and Regional Planning at the University of Texas at Austin, and the Director of the UT Lab for Safe & Healthy Aging. Read her report for the Urban Institute on elderly access to paratransit services here.

For more on demographic shifts, check out our episodes on direct care workers and fertility.

Transcript

Clarrissa Cabansagan: So we live in America, in such isolated single-family homes in suburbs that I fear that this what we call the silver tsunami in transportation, that we're not prepared for it. I think that most of the population will be elderly in a couple of years. And we're already seeing the beginning of people like my parents and my grandparents, who for almost their whole lives have been driving and there are not serious solutions to helping them with their mobility. I do see connections in that new mobility space, as I mentioned that Uber and Lyft example with my mother, but in transportation policy and planning, it’s barely a thing that we talk about, the elderly and their mobility options.

Reem Rayef: The silver tsunami: a probably over-apocalyptic term which refers to our aging population here in the US. More specifically, it describes the fact that by 2034, seniors – or people over the age of 65 – will outnumber children for the first time in American history. According to Census Bureau projections, by 2060, one in four Americans will be seniors.

I’m Reem Rayef, and this is Talk Policy To Me.

We’re in the midst of a series of episodes on demographic shifts, and how policy has caused and responded to these changes in the makeup of our population. As a lover of public transit myself, I wanted to know: How will the silver tsunami impact our transportation systems? And how can we ensure that our aging population maintains its independence and mobility for as long as possible?

As it is, transit ridership is on the decline, and people over 65 only use public transit at about half the rate of the rest of the population. At the same time, we don’t necessarily want elderly folks behind the wheel, as vision and reflexes begin to decline. So what’s the solution? We know that independence and mobility are some of the most important aspects of mental wellness for seniors, so how can we make sure that seniors now, and in the future, remain mobile?

I am a young and able bodied 26-year-old, and in my adult life, I’ve only ever lived in cities with pretty great public transit. So before writing this episode, my take on elderly mobility was this: older folks should obviously just locate in dense cities, if they aren’t there already. In urban cores, they can take public transit to community spaces and cultural attractions and restaurants, they can walk short distances to corner stores and parks, they’re frequently interacting with neighbors, health care services are abundant, and family and friends can visit easily.

But of course, it’s never that simple. So I turned to two experts on transportation and mobility for the elderly to set me straight.

Clarrissa Cabansagan – the voice you heard at the beginning of the episode – is the New Mobility Policy Director at Transform, a Bay Area organization which advocates for green, affordable, and equitable transit systems. And she thinks about this issue not only because it’s her job, but because a lack of transportation mobility impacts her family every day. She illuminates a crucial point, which is that transit and new mobility services, even in urban cores, are inaccessible to the elderly. Personal vehicles still represent a really important part of how they travel.

Later on, I’ll speak with Dr. Sandi Rosenbloom, a professor at UT Austin, about suburban and rural mobility. That’s a crucial piece of this story, since most seniors currently live outside of urban cores, where public transit networks are sparse, and Ubers are hard to come by. Dr. Rosenbloom believes that we can make seniors more mobile through a combination of safety measures for aging drivers, and smarter land use planning in the suburbs.

CC: My family is from the San Francisco Bay Area. My grandmother lives in San Francisco, my mother in Daly City, not too far from one another. But definitely the lower density parts of town that are more car-oriented. So my family mostly grew up driving because transit was infrequent in these parts of town. I'll start with my mom, who five years ago, was diagnosed with lung cancer. And so for her, going through chemo and other treatments made it such that she just could not drive. She was mostly someone who drove and occasionally took BART. But now she's been able to go to medical appointments using Uber. My grandma, on the other hand, lives in San Francisco, half a mile – maybe a quarter mile – from a BART station (Balboa Park) as well as a block from the nearest Muni line. She also hasn't taken transit much apart from BART. I think there's something about, you know, if you're an immigrant, you don't quite understand how to navigate public transit either. It's easier for you to just figure out how to hop in a car and get from point A to point B. I feel like that's been the trend in my family. And so my grandmother has always driven. She's fiercely independent, was a single mother to two kids and wants to stay in her single-family home in San Francisco.

I have a funny story where she tried to take public transit and she didn't know how to look up the schedules. She's horrible on her smartphone. And she just went to the end of the block, assuming that whatever bus was there could take her to where she needed to go. And I think there's a disconnect there of not quite understanding the systems that are in place and then getting frustrated. And she's 86 these days. She's still got her driver's license renewed.

But it's kind of on the onus of family to start to take the keys away from the elderly, and that's challenging for someone who doesn't really have people in house to rely on to travel. She has a roommate like family, friends, but she is still driving and gets in crashes all the time. Not serious ones because she's only driving 30 miles an hour. So local trips, but it's an ongoing thing in my family. How do we get her to stop driving?

It's something that’s near and dear to my heart because I'm either driving people around because of their limited mobility or worried that those that continue to drive because that's the only way to not feel isolated... I fear hurting my grandmother when I'm saying, like, you should just stop driving because I have no real solution for her.

And maybe that was decades of her not being on public transit. It is a shift to then say, try to get on this bus that you've never ridden before and you don't know when you know your geography. Or I guess your cognitive map is so different when you're not in the driver's seat, but you're like on this fixed route and it's moving.

RR: I feel very sympathetic to that notion of like as you're getting older, you lose independence and agency in terms of where you can go and when you can go, just because of your physical limitations.

CC: I also feel like when we run into this a lot, like there is no real travel training available for transit, for example. I draw that kind of comparison between Uber and Lyft and transit. And these companies make it so easy for people to like not know where they are, but they push a button, they say where they're going and the thing gets them there. They don't even have to walk. Sometimes you got to walk. But transit's not as easy to understand. And so for people who aren't aging, they already have that issue of, well, I don't understand this system and it's not easy to navigate. It's much easier to be in my car.

RR: Clarrissa goes on to explain his concept of travel training – a way that public transit agencies can lower the barrier to riding the train or using the bus, so it’s not so daunting in comparison to taking an Uber or Lyft. However, very few cities are investing in these training programs, and those that have them are pretty limited in scope. San Mateo County – which is just south of San Francisco – has free one-on-one travel training for riders with disabilities. Through this program, the San Mateo transit agency teaches riders how to pay fare, navigate stations in a wheelchair, read bus and train maps, and make connections.

But these services are clearly not cutting it, as public transit systems continue to bleed riders.

CC: We’re, one, not investing enough in transit and then even the transit that we do have, you are seeing you know, people argue that there have been drops in ridership for the easier thing of pushing a button and getting to where you need to go.

I think we also need to go back and say, how do we make riding BART, riding the bus, riding whatever train, as simple as that smartphone option. And right now, that's not the case.  Like the way that we configure our transit systems that are not user friendly. Those are barriers to access. And transit operations folks are not thinking necessarily about user experience. These tech companies are all about user experience. Right. So in what ways can transit agencies start to think about how to make that environment friendly to an elderly person?

RR: You’re kind of evoking this idea that if we were to make it easier to ride public transit, in terms of the user experience, and transit agencies were thinking about it in the way that maybe Uber and Lyft are – making it easy and seamless and comfortable and safe to ride public transit, then not only would elderly folks do it, but everyone would do it much more. And then also, I know that you are an advocate for free public transit. But then we're running up against this issue of funding. We're just trying to get the trains to run on time. And so addressing all of these kind of additional questions of how do we make it comfortable and how do we make it very easy to understand. I would imagine that as a transportation planner, it feels like, yes, but let's just get the infrastructure right and let's just get the physical mechanics of it right. And then we can we can improve there. So how do we navigate that tension?

CC: So I'm fascinated by shuttles and what shuttles can do. And I think of things like the Emery-Go-Round in Emeryville where, you know, that's an employer funded thing. But they stop at the BART station. It's wheelchair accessible. It's free for the public because employers paid for it. And then it eventually replaced local bus service that AC Transit used to run in Emeryville. But it's serving the destinations people are trying to get to. It's going to the major shopping centers, it's going to the employment hubs, it's going to BART.

And so when I think of a better version of transit, it's getting the destinations that someone like my grandma wants to go to or is normally going to on that map. I would argue, and TransForm argues, that we need to get the destinations right. We need to think through creative solutions like the Emery-Go-Round that I was talking about. That's a transportation management association (TMA). It's privately run, but it's open to the public for free. And those are transit solutions that are not the norm of a Muni bus or an AC transit bus. But people are riding it.

RR: It sounds like the Emery-Go-Round is a pretty awesome example of a service that serves the exact need of the people who live in that community and that it probably hits kind of all the high points of places that people want to go, like grocery stores and kind of hubs. And it sounds like you're saying that that type of planning is lacking in Muni and AC Transit services.

CC: I think it's just a different goal. So a lot of these TMAs -- I like to bring them up as examples -- their goal is to reduce solo driving. And so they have to provide parking at whatever headquarters like Pixar and Jamba Juice, Peet’s, whoever is in Emeryville. And instead of paying for parking spots, they're paying for the shuttle system. And what you see is this kind of creative way of also getting people to frequent the businesses that are in Emeryville and connecting them to transit. So it's kind of like doing multiple things all in one. I think that the main thing is its goal is to reduce solo driving through being that first last mile from the BART station to these major employer destinations, and tagging on other destinations along the way. But our transit agencies, if they're really just thinking about ridership, they're not able to shift, you know, month by month their service in order to meet that goal. So if a TMA, the Emery-Go-Round, has a mandate to meet this goal of reduced driving, they’re throwing their money at the solution.

The Emery-Go-Round is a perfect example of a transit solution that is really attentive to the needs of a community. It’s flexible -- almost demand-responsive -- and much more manageable for an elderly person to navigate because of its circular route. Clarrissa observes that these public-private stop-gap solutions are better than transit agencies at tailoring routes to riders, and therefore getting riders out of their cars.

However, the Emery-Go-Round is privately funded by the employers in the area. They’re laser-focused on getting their employees to and from work, and their routes are planned accordingly. It’s hard to imagine a private company willing to do something like this that is tailored to elderly ridership – because they aren’t geographically concentrated around a workplace, and they aren’t even employed by the funding organization. So there’s no incentive for the private sector to support elders through this kind of arrangement.

What does this shift toward privatization mean for transit more broadly?

RR: But I want to talk a little bit about how policy and city planning can make new mobility more viable, more cost effective, more equitable. And then I also want to get into this question of what it feels like the transportation management agencies that you mentioned before and Uber and Lyft represent this privatization of transit, which I like to think of as something that should continue to be public and guaranteed and very, very cheap, which privatization presents a challenge to. How can policy and planning make new mobility more equitable? Because right now, for those who are able to use Uber or Lyft or an app that connects them to BART -- would that still be considered new mobility?

CC: Kind of. I consider that new mobility because it's not like it's not a scooter or bikes walking or transit. Right.

RR: But I guess what I'm getting to is that there are still not-insubstantial costs attached to them. And also it seems that what we discussed before is that they're not focused how to serve an aging population.

CC: So we're asking tech companies who are trying to make money off of millennials that locate in urban areas to solve problems that they're not necessarily trying to solve. Right. So I do understand that there's wishful thinking on my part to say that these are the solutions. I do feel like Uber and Lyft are thinking about ADA access and elderly access differently. I know that they have options in their apps that are like if you require more assistance, let us know when there's that toggle that you can choose. I'm assuming that costs more. So I think ultimately my step back is in recognizing that this is the auto industry 2.0. At least two thirds of the Bay Area is driving to work solo. That's a lot of people driving. And so all of those drivers are in a private vehicle that they purchased. And our government is subsidizing the automobile so far outweighing how much we're spending on transit.

CC: So we live in capitalism. And how do we start to undo the impact of capitalism on the way that we move? It's super challenging. So I am a realist in the sense that I'm like, oh, yeah, there are these cars. So how do I get these cars to be more towards the thing that I want -- the sharing? So it's also a wary thing to put your hope in tech to solve the problem. Let's not be naive to think that the Uber and Lyft are going to solve it all for us. But I do see people willing to share. And if that willingness to share, which costs the premium right now, starts to lead to the cheaper option, which is transit that is actually getting people to where they need to go in a reasonable amount of time, then I think that that tech has done its job because we were not seeing that movement prior to.

RR: Clarrissa described an alternative model of transportation that isn’t so dependent on the private sector – instead, it formalized and funded an existing community-based system of carpooling. I think this one is a little easier to envision as a solution for the elderly in more urbanized areas.

CC: Another example I was thinking about was I think this is in Huron. It's called the Green Raitero’s Program. And I think it was funded by California Air Resources Board. But it's a community run shuttle, so people in the community were already giving rides to one another. I mean, there are tons of examples of this in L.A. My friend did his whole thesis on what he called the Bandit Taxis. So pre-Uber and Lyft, there were all these very ethnic specific kind of taxi services where people would just offer rides to people in Koreatown or in the San Fernando Valley, they'd be giving rides to one another. And so in Huron, we see an example of that kind of happening where people were already driving folks to where they needed to go. And you knew who was your driver in the community. And then they were able to get some government funding to formalize it. So it's not like serious on-demand I. don't even know if they have an app attached to it, but they were able to get electric vehicles that in the hands of, you know, this immigrant population, mostly farm workers. I think that's a really good example that we can turn to for the mobility of those in this Silver Tsunami that we’re calling it.

RR: So it's taking kind of what's already happening in the community and providing them with resources to make them maybe even more effective, a little bit greener. That’s awesome.

CC: And so I think if I've learned anything in planning, it's taking a step back instead of applying the flashy object solution, what are people already doing?

RR: It’s clear that even in cities, maintaining mobility of the elderly now and in the future will still require the use of cars. The extent to which that driving can be reduced, however, depends on how much transit agencies can learn from the communities they operate in, from transportation management agencies like the Emery-Go-Round, and even from Uber and Lyft.

But the truth is that the vast majority of seniors don’t live in cities like Clarrissa’s grandmother does. They are situated in suburban and rural areas, either because they’ve lived there their whole lives, or because those are the affordable places to raise a family.

After the break, we’ll talk to Dr. Sandi Rosenbloom, Professor of Community and Regional Planning at UT Austin and Director of the UT Lab for Safe & Healthy Aging. She’s spent almost her entire career researching the travel patterns of the elderly population, and knows that these patterns are largely defined by the elderly population’s concentration in rural and suburban areas.

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Dr. Sandi Rosenbloom: Well, first there is this failure to recognize that over 75 percent of people over 65 in the United States today live in either rural areas or suburban areas. And that's using census data. And census data don't really kroot have a good definition of suburb. So if you live in the jurisdiction, you live in the city limits of a city like Tampa or a city like Orlando or a city like San Antonio or any of the large cities in the south, you could be living within the principal city 30 miles from downtown, whatever -- Orlando, Phoenix -- and you're not considered suburban. So the number I just gave, 75 percent really largely underestimates the number of people who are living at very low density in the United States.

SR: We talk a lot about, oh, the elderly should give up driving and they'll take the little buses that the public transit system runs or in my neighborhood, there's a volunteer driver program or... You know, there's gonna be 80, 90 million older people; they're not all going to get an alternative to the car from the public transit little buses for which they're not eligible unless they have a disability anyway, that’s something that people ignore.

SR: And there's no way to with the existing resources, the existing things we do, to offset any loss of mobility that happens when somebody has to, or wants to, give up driving. And until we accept that, we're never going to figure out the balance between safety and mobility. It is true that on average, as people age, they become less safe drivers. There's a great deal of variability and it takes a long time for an older driver to be as bad as an 18- to 25-year-old male. So we need to understand that most older drivers are safe drivers and most older drivers, when they make mistakes, they’re mistakes. They're not doing anything deliberately. Ultimately, most people should dial back their driving or cease driving. And we are offering them nothing. Absolutely nothing.

RR: Those little buses that Dr. Rosenbloom refers to? Those are what’s called paratransit services. They’re basically free bus services that are provided through public transit agencies to individuals with disabilities who live within a certain mile radius of bus and train lines. As Dr. Rosenbloom notes, they’re really limited in where they go, and who is legally entitled to them, so they only serve a really tiny slice of the population we’re talking about here. She did a really fascinating study with them through the Urban Institute, which we’ll link in the show notes. OK back to Dr. Rosenbloom.

SR: You know, we're just not considering the mobility and access problems of older people and we have no effective way to trade off safety vs. mobility.

RR: I think you frame it really well in some of your writing, where you've said this is kind of like a scam that we’re putting on the elderly community.

SR: I think it is. I talk to people all the time who want to believe there's some option for themselves or for their older parents. And there aren't a lot of options. So there are older parents are going to keep driving until we accept our responsibility and figure out what to do about it.

RR: Moving into how policy and good planning can alleviate this issue and give the elderly population more options for when they want to curtail their driving, but still kind of maintain their mobility and independence: What are the characteristics of a transportation infrastructure system that can make it legible and safe for an aging population? Do we have any good examples of this?

SR: Well, not really. I mean, there are some cities that are doing more than others. But if I were the czar of this, I would first start with ensuring walkable neighborhoods. Now, not necessarily so they can walk to the grocery store. They probably can't. We're talking about low-density suburbs. But the third most common travel mode for older people is walking. The first is driving a car. The second is being a passenger in the car and the third is walking. And mostly those folks are walking for health reasons, for physical exercise, for socializing. And it's a wonderful thing. We should encourage people to walk. So we have to make communities that are walkable, not necessarily for what's called transportation walking, that is to go to a specific site, because that's really hard to do in the suburbs. That may be a long-term goal, but in the short term, you should be able to walk safely in your own neighborhoods.

RR: The emphasis that Dr. Rosenbloom puts on walking was a total surprise to me, but it makes a lot of sense. When we make suburbs more pedestrian-friendly, we facilitate community-building and we might even encourage investments in transit for the suburbs.

SR: We have to start by having a system that you can walk and that would all by itself help support public transportation, even the meager amount of public transportation we have in the suburbs now. Because if you can't walk safely to a bus stop on both ends of the drip, I hasten to add, then you're not going to use public even the public transportation that exists. So that's the. First. The second step is to expand public transportation in the suburbs, and, you know, I'm glad I'm not running a public transportation system. They're asked to do a lot with in general limited funds. And I understand why they do what they do. And if I worked for them, I'd probably do the same thing. But they're not serving the suburbs and they're not serving the trip. Mostly public transportation aims for the lowest common denominator. And older folks who are not in the labor force are generally not going to major employment centers. They're generally not going downtown or to regional centers. They're going to their church, their mosque, their synagogue. They're going to. They like to visit people in in care facilities and in senior centers. They like they like to go to the cemetery and visit people. I mean, try to find a bus that takes you to a cemetery. So it they're just not they're just not appropriate for the trips that older people like to take. Not to mention that getting on a bus and making your way to a seat while the bus is moving is putting your life in danger means it's harder on older people. So the bus is moving and they're trying to move back to a seat. That's a difficult issue.

SR: And there's the safety and security concerns. Waiting at bus stops, waiting on lonely train platforms or light rail platforms. Some of those things, of course, are not unique to older people, but older people tend to be more concerned with personal security.

RR: So if you had to break it down, what are the components of a suburb that is legible for the elderly population in terms of being able to just walk for exercise and walk their dog and also get to the places where they want to go – not just to city centers?

SR: We have to separate the pedestrians from the cyclists and the cyclists and the pedestrians from the cars. We have to rethink some of our engineering...

RR: What this boils down to is making suburbs – where seniors already live – look more like cities. Dr. Rosenbloom mentions a wide range of initiatives that local governments could pursue to make travel for the elderly population – and the rest of their community – safer, easier and cheaper.

Number one is separating pedestrians from cyclists from cars on the road, and optimizing traffic signals to prioritize safety rather than traffic speed. It’s a natural extension of Dr. Rosenbloom’s emphasis on expanding walkability.

Another priority is densification. This looks like providing incentives for developers to build around transit hubs, and legalizing the construction of backyard cottages and in-law suites, so elderly folks can co-locate with their families while maintaining their independence. Densification may also facilitate co-housing among elderly people – something which remains fairly uncommon now but could represent a way forward for single or windowed seniors.

And finally, Dr. Rosenbloom hits on the favorite subject of all city planners – affordability. Elderly folks who are no longer working can’t move to denser areas if those areas are prohibitively expensive, like San Francisco. Cities that want to encourage densification near transit must make that new development affordable and accessible. And cheap, dense suburbs mean better mobility for all.

And for those who still need a car to get around? We shouldn’t be so hasty to pump the brakes.

SR: So first, they should make sure their car is adapted to their needs, their height and so forth. The second thing is there are a lot of courses that Triple A gives, that that other organizations give, about how to be a safe driver, reminding people of traffic laws. You know, most people got their driver's license 40 years or 50 years or 60 years before, and they may not know all the rules or the new rules. And so it's useful to get a refresher course on that.

SR: We need to be helping them develop tricks if they haven't already to self-regulate their driving, like making three right turns instead of making a left turn. Left turns are very problematic for older people. And one of the major causes of crashes is turning left at an intersection. And again, it's not because older people are doing anything particularly risky or dangerous. They're not trying to beat the oncoming traffic, but they miscalculate the distance in the speed at which the oncoming traffic is approaching, so they get hit.

RR: It sounds like those ideas put a lot of impetus on the elderly driver themselves or the family around them. So I'm wondering, how should policy support those efforts?

SR: Well, I mean, we have to make them widely available and encourage older people to use them and policy can do that. Planners don't think about that stuff much, partially because they're so anti-car. That has to be part of our toolkit. All of these educational and training things have to be part of the toolkit.

RR: At the end of our conversation, I asked Dr. Rosenbloom if she thinks this trend of older people moving out to the suburbs – and staying there – will persist.

SR: You see in the press a lot of talk about how many older people are going to move to downtown. And then every once in a while, there's a story about a retired couple who moved from their three thousand square foot house in the suburbs to downtown Los Angeles or Boston or Orlando or wherever. And the reason the press is covering a story like that is because it's the exception, not the rule. They rarely write stories about what everybody is doing. In fact, the data show exactly the opposite. First of all, older people don't move very much and that the percentage of older people who move home in any given year has been dropping for 30 years. It's been dropping as home ownership rates go up. Once you own a home and you hit 55 or 60 or 65, it's very unlikely you're going to move out of that home. So you're going to stay in the suburban neighborhood where you raised your kids. You're not going to pick yourself up and move to downtown.

That's not what's happening. So we have to we have to recognize what's going on.

RR: So you've kind of dismantled this myth that there is any kind of trend of the elderly population kind of moving into cities.

SR: No. The census clearly shows that this is not hidden stuff that planners would do evidence-based planning. They would see the data are overwhelming.

RR: But I wonder if that trend might reverse moving forward just because there's all of this. I don't know if it's speculation. I think it's actually a research showing that in the future, my generation, for example, I'm 26 years old, we will be way less likely to own our homes and we might be more likely to continue renting and maybe living in cities, because that's our preference. So I wonder if maybe --  [25.4s]

SR: Do you have kids? How many kids do you have?

RR: I have zero kids.