370 / 2019-02-12 01:30:54

Daily transport and depression among older adults: examine England’s free bus policy

public transportation, depression, older adults, free bus policy, England

全体主题 > Agent-based modeling

Daily transport may impact depression risk among older adults through several pathways including facilitating the ability to meet basic needs, enabling and promoting contact with other people and nature, and promoting physical activity (e.g. through active transportation such as walking or walking to public transit). Public transit is an important option to fulfill the daily transport needs of older adults. Driving becomes a less feasible option as people age as a result of cognitive and physical factors. Despite longer durations than automobile trips, public transit use has a number of benefits including free time on board, engagement in physical activity (e.g., through walking to bus stations), and being environmentally friendly (e.g., reductions in gasoline consumption, congestion, and land for parking). However, large variations in public transit use exist between countries and, overall, public transit use is low in high-income countries. Recent several countries have implemented reductions in bus fares or free bus passes for older adults as a potential policy to promote public transit use. Although the free bus policy in England proved to be effective, its impact was moderate at best as the policy was associated with an 8% increase in any public transit use and a marginal decline in depressive symptoms, despite the large scale effort and investment. It is important to investigate why the policy was not more effective, whether additional complementary strategies can be used to increase its effectiveness, and whether the policy is likely to be more beneficial for some groups of older adults than for others. We adapted a previously published framework and ABM. The model includes about 18,500 older adults (i.e. agents) between the ages of 65 and 85 years old, living in a hypothetical city. The city has a grid space with a number of neighborhoods and locations. Key dynamic processes in the model include aging, daily transport use and feedbacks, and the development of depression. Key parameters were derived from England data sources. The model was validated using empirical studies. Results indicate that the free bus policy alone may not be adequate to enable older adults to use the public transportation, and there are other barriers needed to be addressed such as the comfort level and related social norm towards bus use. The impact of a free bus policy varies to different subgroups of older adults, for example, those with varying levels of household income. The presence of strong residential segregation can create further complexities. To promote daily use of public transport, policies need to be tailored to each specific group.