Investigating the role of public transit on health behaviors among older adults with disabilities - 11.2 million (23.5%) older adults report difficulty traveling outside their homes, making limited transportation an important determinant to health. With over 7 million non-driving older adults and 7-10 non-driving years at the end of life, alternative transportation options are needed. Lack of universal design features in public transit can disproportionally harm older adults with disabilities and may impact health behaviors, such as physical activity and social participation. Physical activity and social participation are key components of healthy aging, associated with cognition, quality of life, and mortality. To this end, identification of modifiable public transit features, and their impact on physical activity and social participation among older adults with disabilities is critically needed. Neighborhoods with greater density of public transit stops are associated with walking for exercise among older adults, and public transportation use is a strong mediator of this effect. Through the collection of primary data using a novel scoring system, I measured information about universal design features of public transportation available to the public. Preliminary findings indicate high levels of inter-rater reliability among individual items and composite scales. These data and causal methods will be leveraged to elucidate mechanisms and modifiable intervention targets. Specifically, the research conducted during the R00 independent research phase will address the following aims: 1) Examine if self-reported public transit use is associated with physical activity and social participation among older adults with and without disabilities, 2) Determine if universal design features of public transit systems are associated with physical activity and social participation behaviors among older adults, 3) Test the hypotheses that public transit use partially mediates the link between public transit features and (a) physical activity and/or (b) social participation among older adults. The proposed use of NHATS, a rich, integrated data source will allow for investigation into whether public transit use interacts with disability status to result in differential physical activity and social participation (Aim 1); if the density and universal design features of public transit systems interact with disability status to affect physical activity and social participation (Aim 2); and the mechanism through which disability, public transit features, and public transit use shape physical activity and social participation among older adults (Aim 3). This research will examine if universal design features of public transit systems are associated with physical activity and social participation among older adults with disabilities, a potential intervention target to optimize older adults’ ability to age in place. The findings from this work will inform transportation development and planning about public transit systems which provide universal access to older adults with disabilities.
