Physical Activity Implementation Guide
Boosting physical activity among adults with arthritis

Transportation, Land Use and Community Design


What Can You Do?

Transportation systems, development patterns, and community design and planning decisions all can have profound effects on physical activity. People can lead healthier, more active lives if our communities are built to facilitate safe walking and biking and the use of public transportation, all considered forms of active transportation.”

A few tips

As you think about how best to use your resources and capabilities to make it easier for adults with arthritis to access public transportation and fully utilize community assets, consider the primary environmental barriers they face:

  • Transportation – including lack of transportation to facilities or programs as well as placement of new facilities and programs in locations that are not accessible by public transportation
  • Built environment – including no safe curb cuts (depressed curbs that act as ramps in sidewalks), damaged sidewalks, no sidewalks, terrain, too steep a grade or slope, unsafe neighborhoods, slippery or impassible sidewalks, insufficient number of resting places on streets and trails for people who need frequent rest periods, and poor and/or confusing signage
  • Environmental conditions – congested parking, concrete surfaces, and presence of dogs
What strategies will make the most difference?

Literature reviews and expert interviews reveal several helpful environmental and transit features to overcome major barriers:

  • Pedestrian oriented designs – continuous, smooth sidewalks, four-way stop signals, adequate street lighting, and other pedestrian amenities support physical activity and reduce obesity. These include walk signals at street crossings that include a count down with enough crossing time for people who move more slowly and pedestrian refuge islands in the middle of any street crossing that is four or more lanes wide.
  • Barrier-free walkways – curb cuts, smooth pavement, and barrier-free sidewalks can easily prevent mobility disability and promote independence in adults at greatest risk, such as those with underlying weakness in movement-related functions and balance or who use assistive devices.
  • Rest spots – placement of benches and other resting structures, prompt attention to needed repairs, overhangs or “roofs” to shield from inclement weather can make a significant difference for someone who was previously unable to navigate outside independently because of impaired gait or balance or use of an assistive device.
  • Transportation enhancements – services must accommodate persons with disabilities and/or limited mobility and comply with the Americans for Disabilities Act in order to facilitate widespread and universal access to community resources for all people. This includes training of bus drivers and other transport workers to understand and support the needs of adults with arthritis.
  • Cross walks – at regular intervals with clear signage, auditory and visual promptings, and sufficient time to cross are important for slower walkers. In addition, curb bulbs (sidewalk extensions into an intersection that shorten pedestrian crossing distance) allow pedestrians to be seen by approaching traffic and enable pedestrians to see beyond parked cars.
  • Inclusion of Universal Design features in transportation planning–
    • Increase the time both between fare payment and opening of turnstiles and between opening and closing of turnstiles
    • Consider vehicles that have low floors, high ceilings, and wide door openings for easy entering and exiting
    • Complete streets that provide access for all modes of transportation including walking
    • Safety and security features – some approaches relate to road traffic: lower traffic speeds, restricted free right turns, traffic calming around senior centers or senior residences. Others involve emergency call phones in parks and on trails, safety from crime (the more people and eyes on the street, the better) and safety in being able to cross the street without getting stuck in the road (with sidewalks and cross walks). Safety can be promoted through environmental features such as lighting, but also through community groups including walking groups or law enforcement presence. Walking with a companion is safer than walking alone and has social benefits. Older adults might consider volunteering in safe routes to school programs (for which funding is allocated) that will foster community cohesion and may include facilities improvements like cross walks.
    • Signage – to indicate when roadways or paths are impassable or under repair. Areas without sidewalks in residential or shopping areas, particularly where there is already significant traffic, may be a deterrent to walking for people with arthritis or physical limitations.
To learn more

Learn the Truth about Arthritis

Clarke P, Ailshire JA, Bader M, Morenoff JD, House JS. Mobility disability and the urban built environment. Am J Epidemiol 2008;168(5):506-13.

National Association of Area Agencies on Aging. A Blueprint for Action: Developing a Liveable Community for All Ages..

Easter Seals Project ACTION

U.S. Department of Labor's Office of Disability Employment Policy -- Disability.gov. Transportation Accessibility Tools and Guidelines.

Access Board. Draft revisions to the ADA accessibility guidelines for buses and vans.

Mitchell C. Pedestrian mobility and safety - A key to independence for older people. Topics in Geriatric Rehabilitation 2006;22(1):45-52.

Rehabilitation Engineering Research Center on Accessible Public Transportation (RERC-APT) at Carnegie Mellon University and the University of Buffalo -- Unpublished Data. Cited in "Universal Design & Accessible Transit Systems: Facts to Consider when Updating or Expanding your Transit System"

Outdoor built environment barriers and facilitators to activity among midlife and older adults with mobility disabilities

The Role of the Built Environment in Healthy Aging Community Design, Physical Activity, and Health among Older Adults

Active Living Research

AARP Public Policy Institute’s Planning Complete Streets for an Aging America

http://assets.aarp.org/rgcenter/il/2009_02_streets.pdf

Crime Prevention and Active Living

National Center for Safe Routes to Schools

California’s Health in All Policies Issue Brief on Transportation and Health

The Effectiveness of Urban Design and Land Use and Transport Policies and Practices to Increase Physical Activity: A Systematic Review

Nebo Content Management System Tracking