5.0 TRANSPORT, HOUSING AND PLANNING
Housing, Transport and Planning
- Access to transport is important for older people to maintain a good quality of life: Although there has been an increase in the number of older households owning cars, car ownership continues to fall as people age, as does the frequency of driving, particularly among females. Access to good local public transport is therefore vital for older people. As people age they are less likely to make a journey, but when they do they are heavily reliant on local bus services.
- The local physical and social environment becomes increasingly important as people age and can impact upon their mobility, health and general well-being.
Physical:
Although older people are more likely to use local services they are less likely to find them convenient.
Social:
Older people are more likely to feel positive and involved in their local community than younger people.
- Housing trends have implications for the provision of housing for older people:
These include: - An increase in the number of older people owning their own homes.
- Older people as a group, particularly those who own their own homes, being more likely to be fuel poor.
- A projected increase in the number of older people living alone, particularly older men. A desire among older people to remain in their own homes as they age, which has implications for the provision of home care and aids and adaptations.
The environment, both physical and social, where older people live is important for their mental well-being and public health. This chapter considers three key elements in relation to older people's environments: housing, transport and local neighbourhood. First, it considers housing issues including tenure and housing quality. Second, it looks at travel and transport use among older people including how frequently they travel, reasons for travelling and the mode of transport used. Lastly, this chapter examines how involved older people feel within their local neighbourhood and their use, and perceptions, of local services.
Housing
Housing issues, including tenure and housing quality, are of fundamental importance to the health and independence of older people 102 103. This section considers the key trends relating to the housing of older people including changes in tenure patterns, the problems of fuel poverty among older households, and changing household types. It goes on to consider what expectations and aspirations older people have in relation to their housing and changes in the provision of home services and specialist housing.
Tenure
As Figure 52 below illustrates most people in Scotland are owner-occupiers (70%), either owning their property outright or buying with the help of a mortgage. Although owner occupation has been rising among all age groups, the rate of increase has been more marked among older people. Among the 16-49 year age group, owner-occupation rose very slightly between 1999 and 2005 from 66% to 68%, compared to an increase from 52% to 63% among those aged 75 years and over. Owner-occupation peaks among the 50-59 year age group (at 77%) and then gradually decreases with age.
Figure 52: Tenure by age group and year
Source: Scottish Household Survey (2005)
Renting from a social landlord is much more common among people over the age of 70. However, the percentage of adults renting from a social landlord has been decreasing rapidly among older age groups. For example, between 1999 and 2005 social renting fell by 10% among those aged 65-69, by 9% among those aged 70-74 and by 13% among those over the age of 75. This compared to a decrease of 6% among the 16-49 year age group.
Fuel Poverty and Energy Efficiency
The proportion of households which are fuel poor 104 increases with the age of the head of household. 6% of homes with a head of household aged 16-49 are fuel poor compared to nearly one-third (32%) of those with a head of household aged over 75 years.
Among people over the age of 60, a higher proportion of owner occupiers are fuel poor compared to those who rent (for example, among those over the age of 75, 43% of owner occupied households are fuel poor compared to 20% of those in the rented sector).
As Figure 53 below illustrates, older smaller and single pensioner households are most likely to be fuel poor.
Figure 53: Proportion of Fuel Poor Households by Household type
Source: Scottish House Conditions Survey (2003)
The proportion of households with a 'poor' energy efficiency rating 105 also increases with age. For example, 8% of homes with a head of household aged 16-49 have a 'poor' rating compared to 12% of those with a head of household over the age of 75 years. Similarly, the proportion of households with a 'good' energy efficiency rating decreases with age - from 34% of homes with a head of household aged 16-49 to 28% of those with a head of household over the age of 75.
Among those over the age of 70, a higher proportion of owner occupied households have 'poor' energy efficiency compared to those who rent (among those aged 70-74, 10% compared to 7%, and among those over the age of 75, 15% compared to 8%).
Living Arrangements
Older people are more likely to live alone as illustrated in Figure 54. 12% of those aged 16-49 live alone and this figure increases with age, reaching a peak of 54% among those over the age of 75. Women are more likely to live alone than men, and this is more marked as age increases (19% of women aged 50-59 live alone compared to 15% of men; 63% of women over 75 years live alone compared to 36% of men).
This trend is set to continue and there is a large projected increase in households containing only one adult, from 34% of households in 2004 to 42% of households in 2024. However, the number of older men living alone is projected to increase more rapidly than that of women (from 330,000 households in 2004 to 490,000 in 2024). 106
Figure 54: Proportion of adults living alone
Source: Scottish Household Survey (2005)
Urban Rural Distribution
As Figure 55 demonstrates, rural areas have a lower percentage of the younger population and a higher proportion of the older population compared to urban areas. This is particularly apparent in the 50-64 year age band. Similarly, rural areas have a higher percentage of households with older adults (two or more adults with one or both of a pensionable age) than the rest of Scotland.
Figure 55: Differences of age distribution of population of rural areas, relative to rest of Scotland, 2004
Source: Rural Scotland, Key Facts 2006: People and Communities, Services and lifestyle, Economy and Enterprise. Scottish Executive
All of these trends have a number of implications for the provision of housing for older people. Added to this are the changing aspirations and expectations of older people.
Older People's Housing Aspirations
It is well documented in the literature that as people age they prefer to stay in their own homes. Evidence shows that four-fifths of older people would prefer to live in their own homes and that older people are reluctant to move into residential or nursing care. 107
As people age they want to continue to be able to make informed choices about their housing and have a say in their housing options and solutions reflecting a keenness to retain their independence. 108
Older people have rising expectations about the range, quality and size of housing they would prefer 109 and, in particular, the next generation of older people will have spent their lives in good quality housing. 110
However, older people are not a homogeneous group and have varying aspirations and expectations. The decision about where to live and when to move is complex and highly dependent upon individual circumstances, including health status.
Housing Options: Staying Put vs. Moving On
There are many positive reasons for people remaining in their own homes as they age including having more control and independence, emotional and practical ties, and sufficient space. However, staying at home can also be influenced by more 'negative' reasons including a lack of realistic alternatives, not having enough information about alternatives, and fear of change. Older people also fear losing their home and savings by moving to residential or sheltered accommodation. 111
Enabling people to remain in their own homes as they age is dependent upon a number of factors, including the physical design of the house and the availability of home support.
Physical design of house
Housing needs to be suitable for people at all stages of their lives. 112 Therefore, main facilities and living areas may need to be adapted as people age, so that the home remains accessible and older people maintain an independent lifestyle, with good quality of life .
However, more recently it has been argued that a more inclusive approach to housing design should be adopted to ensure that housing meets the needs of all members of the community, regardless of their age and mobility needs. 113 This concept of 'lifetime homes' is based on the premise that most of the difficulties currently experienced in mainstream housing can be eliminated by some simple design modifications to 'ensure that no one is the victim of architectural discrimination'. 114
The concept of lifetime homes ensures flexibility in design in order to support people's changing needs and functional capacity. For example, through planning stipulations it covers access to the home, the layout and facilities inside the home as well as the accessibility and design of fixtures and fittings.
Home Support
Although the majority of older people do not require support or assistance to maintain an independent and active life, the need for support does increase with age.
As people age they are more likely to have a long-term illness or disability. For example, 15% of those aged 16-49 years have a long-term illness or disability and this figure increases with age to 27% of 50-59 year olds, 36% of 60-64 year olds, 41% of 65-69 year olds, 45% of 70-74 year olds and over half of those aged over 75 years (56%). 115
The Scottish Household Survey collects information on activities people find difficult. However, this information is only collected for households where a member has a long-term illness or disability. It does not collect this information for older people who do not class themselves as having a long-term illness or disability. Among those with a long-term illness or disability, activities found difficult increases with age. As illustrated in Figure 56 below, this includes climbing stairs, doing housework, preparing main meals, dressing and washing.
Figure 56: Activities found difficult by age group
Source: Scottish Household Survey (2005)
This has implications for the level of support which people may need as they age, particularly if there is a desire among older people to remain in their own homes.
Within Scotland, there are three main forms of support provided to people at home:
Housing Support. Older people can access a range of different housing support via the Supporting People Programme. This includes help with claiming benefits and managing money, basic cleaning and shopping support, support in staying safe and secure at home, accessing other specialist care, support and housing services, and linking older people with social and leisure activities. In 2004-05, 82,968 older people received assistance from the Supporting People programme in Scotland. 116
Property related services including care and repair services, handy person's schemes and garden maintenance, equipment and adaptations and central heating programme. For example, the Scottish Executive Central Heating Programme was introduced in 2001-02 and provides central heating, insulation measures, energy efficiency advice and a benefits entitlement check to private households where the householder or their partner is over the age of 60 and has no central heating system or one that is broken. For households where the householder or partner is over the age of 80, the programme also upgrades or replaces partial or inefficient systems. 117 Care and repair services and the fitting of equipment and adaptations enables people to stay at home longer. 118 In a qualitative study in England, Heywood 119 found that minor adaptations, such as handrails, had lasting and positive consequences for those who had received them including feeling safer from the risk of an accident and a perceived positive effect on health. Similarly, major adaptations, such as bathroom conversions and lifts, had 'transformed' people's lives. Adaptations may be particularly important in circumventing an unwanted move into alternative accommodation, or facilitating a move back home following time in hospital.
Again, the Scottish Household Survey collects information on the aids and adaptations used for those households where a member has a long-term illness or disability. The most common aids and adaptations used were handrails, walking stick/crutches and bath/shower seats.
Although the evidence indicates that most older people would prefer to stay in their own homes, there will continue to be a significant minority of older people who require higher levels of care and support that cannot be realistically delivered at home.
The decision to move is often influenced by 'push' factors away from the existing home, for example insufficient care, rather than 'pull' factors to a new home. 120
As illustrated in Figure 57 below more older people report that they are not likely to move within the next five years. For example, just under one-third (32%) of those under the age of 50 report they are likely to move compared to only 4% of those over the age of 75.
Figure 57: Likelihood of moving within the next 5 years
Source: Scottish House Conditions Survey (2002)
Specialist Housing
Specialist housing is often viewed as a positive choice for many older people 121 as it provides social contact, a secure environment, flexible care and accommodation suited to those with mobility problems. However, older people may resist moves to specialist housing on the grounds of restricted space, the concentration of older people and the implication of loss of independence. 122
Within Scotland, the provision of specialist housing for older people has increased in recent years. The provision of very sheltered housing has increased from 671 places in 1995 to 3,893 in 2005, while the number of sheltered housing places has increased from 31,897 in 1995 to 33,936 in 2005. 123
During the same period, there was a fall in the number of places in medium dependency housing, from 17,424 in 1995 to 13,413 in 2005.
Care Homes
There is a continued need for the provision of care homes for those who are too frail and vulnerable to live in their own home, although these are often acknowledged as a last resort among older people.
With the increase in home care provision and specialist housing, there has been a simultaneous decline in the provision of care homes. The number of care homes in Scotland has decreased from 1,060 in March 2000 to 969 in March 2005. Similarly, the number of residents in care homes has decreased from 34,402 in March 2000 to 33,716 in March 2005. 124
Transport
Access to transport can influence older people's well-being 125 and car ownership and access to transport have been found to be independent predictors of quality of life.This section considers how frequently older people travel, their reasons for travelling and the mode of transport used. It also considers how frequently older people use local bus and train services. All of the information presented in this section is from the Scottish Household Survey, unless otherwise indicated.
Travel Behaviour
The majority of older people in Scotland had made a journey the day before taking part in the Scottish Household Survey interview, 126 although the proportion falls with age. For example, 72% of those in their 50s had made a journey compared to less than half of those over 75 years (44%). The main purposes of journeys made by older people were for shopping, visiting friends and relatives and other personal business.
Access to cars and use
Household car accessibility varies strongly with the age of head of household. As illustrated in figure 58, car ownership peaks in households where the head of household is between the ages of 50 and 59 and falls away as age increases. For example, 78% of households where the head of household was aged between 50 and 59 own a car compared to just over one-third of households where the head of household was over the age of 75 (36%)
Figure 58: Cars available for private use
Source: Scottish Household Survey (2005)
There has been an increase in car accessibility in recent years and the most significant increase has been among older households. For example, between 1999 and 2005 households having access to one or more cars increased by 4 percentage points for heads of household aged 16-49 compared to 9-10 percentage points for heads of household aged over 65.
Frequency of Driving
People under the age of 60 are most likely to drive every day (48%) and this falls as age increases. For example, 36% of those aged 60-64 drive every day compared to just over one-tenth (13%) of those over 75 years. There is a clear difference between men and women in terms of frequency of driving, with men more likely than women to drive every day for all age groups, with the gap widening as age increases as illustrated in Figure 59 below.
Figure 59: Driving licence possession and frequency of driving by sex and age
Source: Scottish Household Survey (2005)
Public transport
As people age, car accessibility reduces and they become increasingly dependent on public transport. This section looks at older people's use and perceptions of bus and train services.
Use of Bus Services
The use of bus services is greater for those who are over 60 years old. 34% of 50-59 year olds had used the bus service in the past month, increasing to a peak of 50% of 70-74 year olds, tailing off slightly for those aged 75+ (45%). 41% of those aged 16-49 had used the bus in the past month.
Use of Train Services
The use of train services shows a different pattern. They are used less frequently than bus services by all age groups (17% compared to 41%). Older people are also less likely to have used train services in the past month than younger people. Just over one-fifth (21%) of 16-49 year olds had used the train in the past month and this figure gradually falls as age increases - 15% of those aged 50-59, 14% of those aged 60-64, 12% of those aged 65-69, just over one-tenth of those age 70-74 and falling to 6% of those aged over 75.
All age groups showed a higher level of both bus and train use in urban areas than in rural areas. In general, adults with a long-term illness or disability were more likely to use the bus and less likely to use the train than those with no disability or long-term illness (43% vs. 41% for buses, 10% vs. 19% for trains). However, those over 60 years old are less likely to use a bus if they have a disability or long-term illness; for example, 54% of over 75 year olds with no long-term illness or disability have used the bus in the past month compared to 37% of those with a long-term illness or disability.
Older people were more likely to think that buses ran on time (78% of people over 75 years agreed with this compared to around 70% of those aged under 60) and that fares were good value (80% of people over 75 years compared to just under two-thirds of those aged under 60). They were less likely to think that tickets were easy to understand (86% of people over 75 years compared to about 91% of those aged under 60) and that changing to another mode of transport was easy (68% of people over 75 years compared to around 72% of those aged under 60).
As people age health related reasons inhibit more frequent use of bus services. For example for those who do not use bus services more than once a week the number citing health reasons increases from 4-8% of those aged under 60 to 40% of those aged over 75
Older people were more likely to think favourably about trains than younger people with the biggest difference seen in thinking fares were good value (83% of people over 75 years compared to 54-61% of those aged under 60).
Concessionary fares
In 2005, 26% of adults held a concessionary travel pass. 127 As Figure 60 demonstrates, possession and use of a concessionary travel pass is linked with age. 2% of those under the age of 50 have a pass, compared with 5% of those in their 50's, 70% of those aged 60-64, and 83-87% of those aged 65 and over. 81% of those aged 60 and over held a concessionary pass; 75% of men and 85% of women. Possession of a concessionary pass also varies with income. For example, over four-fifths of those aged 60 and over living in households with an annual net income of under £15,000 have a pass, compared to 68% of those in households with a net income of over £20,000. Around 85% of people aged 60 or over in urban areas held a concessionary pass compared with just over two-thirds of those
in rural areas.
Figure 60: Possession and use of concessionary travel passes
Source: Scottish Household Survey (2005)
44% of women aged 60 and over had used the pass at least once a week in the past month compared to 32% of men. Adults aged 60 and over who lived in households with an annual net income of less than £10,000 were much more likely to have used their pass at least once a week than those in households with an income of more than £20,000. 52% of adults aged over 60 years in large urban areas had used their pass at least once a week in the past month compared to 13% in remote rural areas.
Neighbourhoods
As people age and become less mobile, their immediate physical and social environment becomes increasingly important and can facilitate their mobility, health and sense of well being. 128 Their local neighbourhood will constitute a larger part of their social landscape within which most of their life will take place. Greater social integration can lead to more positive outcomes in later life. 129
Perceptions of, and involvement in, neighbourhoods
Older people are more likely to rate their neighbourhood as a 'very good' place to live than their younger counterparts. 130 For example, 45% of 16-49 year olds felt their neighbourhood was a very good place to live and this figure increased with age, peaking at 65% of those over the age of 75.
As Figure 61 below illustrates, older people are more likely to cite good neighbours, friendly people and it being quiet and peaceful as aspects of their neighbourhood they particularly liked. However, they are less likely than younger people to cite the convenience of local services (including convenient shops/other amenities, good local shops and good local leisure facilities).
Figure 61: Aspects of neighbourhood particularly liked by age
Source: Scottish Household Survey (2005)
As Figure 62 illustrates, older people are more likely to feel involved in their local neighbourhood than their younger counterparts. They are more likely to agree that they can rely on friends/relatives in their neighbourhood for help and to look after their home and that they can turn to them for advice and support. For example, 84% of 16-49 year olds agreed they could turn to friends/relatives in their local neighbourhood for advice and support compared to 91% of those over the age of 75.
Figure 62: Involvement with other people in the neighbourhood by age group
Source: Scottish Household Survey (2005)
Convenience and use of local services
The convenience of local services becomes increasingly important as people age. For example, getting to the shops is not only about purchasing food but it is also about encountering friends in the street which can reinforce older people's sense of being part of a social community. 131
As people age they are less likely to find local services convenient, including for example cash machine or ATMs, police stations, a hospital outpatient department, a petrol station and a public telephone box. Those over the age of 75 are particularly less likely to find local services convenient. For example, 87% of 16-49 year olds find cash machines or ATMs convenient compared to 63% of those over the age of 75. Similarly, 79% of 16-49 year olds find a petrol station convenient compared to just over half of those over the age of 75 (53%). 132
In contrast, older people are generally more frequent users of local services including post offices, banking services, doctors and hospital outpatient department than younger people. For example, those using a post office more than or about once a week peaks among the 70-74 year age group and then falls among those over the age of 75.
Older people in rural areas are more likely to be frequent users of local services than older people in urban areas. For example, as demonstrated in Figure 63 below, 75% of people aged 70-74 in urban areas use a post office about once a week or more compared to under half (47%) of those in large urban areas.
Figure 63: Use of post office by age and urban rural classification
Source: Scottish Household Survey (2005)
People in rural areas are generally less likely to find most local services as convenient as their urban counterparts. For example, 92% of those in large urban areas find a chemist/pharmacist convenient compared to 70% of those in remote rural areas.