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Abstract
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Background
This paper examines the literature on rural transport and social exclusion in regard to the potential health impact in the older population (defined as those aged 60 and over).A lack of access to affordable transport and rurality have been identified as contributing significantly to social exclusion. People are living longer, predictions indicate that by 2024 more than one in four UK residents will be over 60. The ageing process has implications for mobility, this is particularly associated with wellbeing for older people. While previous literature reviews have examined transport related social exclusion, none have addressed it's associated health impact. By acknowledging that social exclusion is a multi-disciplinary concept this review extends existing research to include the health impact of transport related social exclusion
Methods
Database searches identified 751 studies. Of these 32 were identified as pertinent. Search criteria comprised of transport related social exclusion, older populations and rural communities in developed countries. Qualitative and quantitative articles from peer reviewed journals between 2000 to 2017 were reviewed.
FINDINGS were analysed using themes of social exclusion, wellbeing, rurality, older age, accessibility and public transport.
Results
Results of the literature review found that older people in general, make fewer, shorter journeys than other age groups. In rural areas, where public transport is unavailable and for those older people who do not have a car, there appears to be a tendency to utilise car-pooling and social networks to access essential services such as doctor's surgeries, hospitals and shopping. Additionally, results highlighted the unmet needs of older people in rural communities. Difficulty accessing public transport presents a barrier for older people's independence and freedom to make leisure trips such as visiting friends and relatives. This presents a physical and mental health disadvantage, particularly for those older people who live alone.
Conclusions
In conclusion, the prevalence of older people relying on social networks and car-pooling for their essential transport needs appears to indicate a disconnect with public transport providers and healthcare services. There are obvious synergies here presenting opportunities to forge links and overcome barriers faced by older people in accessing transport particularly for leisure. Future research should explore these synergies and the potential for community led, demand responsive transport with multi stakeholder engagement. This review highlights that access to public transport in rural communities is an important factor in mitigating social exclusion for older people, their physical and mental wellbeing and maintaining an active lifestyle. |