Do pedestrian safety improvements affect older adults' health and social outcomes equitably? A quasi experiment in Singapore

Abstract

IntroductionPedestrian-friendly neighborhoods are believed to encourage greater social participation, community engagement, and sense of social inclusion, which are important to older individuals at higher risk of being socially isolated. However, most studies on neighborhood walkability, social participation and social inclusion are cross-sectional, making it difficult to robustly establish causal links. Much research on neighborhood walkability is also based in North America and Europe, leaving a knowledge gap on the impact of walkability within other geographic contexts. Furthermore, there is a lack of empirical evidence about whether benefits from traffic calming schemes are distributed equitably. To reduce these empirical gaps, our study capitalises on a ‘quasi-experiment’ to estimate the impact of an infrastructure-focused pedestrian safety program “Silver Zones' in Singapore, a highly urbanised city state in Southeast Asia with an aging population. MethodsThis study utilises panel data from a high-frequency internet-based survey of older adults that has been administered from 2015 till present. We examine how changes in older residents' residential proximity to Silver Zones relate to changes in their social and health outcomes. We also test whether the relationship between Silver Zones and older individuals' health and social participation outcomes might be moderated by age and socioeconomic class. Finally, we interpret these findings in view of participants’ perceptions of Silver Zones. Results and conclusionWe find that the oldest participants with low SES -- a particularly vulnerable subgroup -- experienced negative changes after the opening of Silver Zones near them, as did those classified as mid SES. In contrast, our findings suggest that new Silver Zones might have a positive effect on older adults of high SES. These findings suggest that there might be inequities in the impact of pedestrian safety programs on residents' social outcomes. Additionally, while our findings were statistically significant, they also suggest that Silver Zones’ contribution to changes in participant outcomes were relatively small, which might be due to a mismatch between perceptions of Silver Zones, actual exposure, and participant outcomes. Our findings underscore the need for more outreach and publicity campaigns around pedestrian safety initiatives, as well as the importance of going beyond self-reported perceptions when assessing the success of pedestrian safety schemes like the Silver Zones.