TORONTO - Lucy Howe rides a scooter to get around but she bounces uncomfortably when the sidewalks are rough and cracked. Curb cuts that form ramps for getting across the street aren't always wide enough for the scooter, and it's especially difficult in winter.
"I've tipped mine. I've fallen," said Howe, who was at the York West Active Living Centre on a recent weekday preparing to settle in for an afternoon of playing euchre. "We've both fallen over together — me and the scooter. My ankle went underneath it, and it was a few weeks getting that healed up."
Howe, 68, has scoliosis and a lung condition similar to COPD, which means she's on oxygen.
A lot of people with disabilities live in her neighbourhood and the sidewalks aren't all wide enough for them, she said. In addition, crosswalks flash the "Don't walk" signal too soon for people with mobility problems trying to get across several lanes on busy streets.
"Even with a scooter sometimes, you're just making it," she lamented.
As the population ages, city planners in many communities across Canada are teaming up with health researchers to listen to concerns like Howe's, and to understand more about how the physical and social environment affects health, social connectedness and mobility.
Joanie Sims-Gould of the Centre for Hip Health and Mobility, located in Vancouver General Hospital, was among the researchers who got together for a symposium earlier this month called "If we build it, will they walk?" Perspectives were shared by civic planners, engineers, elected officials, seniors and experts in disciplines such as physiotherapy, geography, epidemiology, social sciences and bone health.
"What we're looking at is how where you live influences basically what you do, how you move about in your environment — so if you live in a walkable versus a not-walkable area, how that may or may not impact physical health," explained Sims-Gould, a lead researcher on the project.
"We're particularly interested in how that impacts older adults and particularly those vulnerable older adults who are vulnerable either through health-related vulnerability or income-related vulnerability."
It's vital to consider the needs of older adults because of the demographic shift to an aging population, but it's believed that all ages would benefit from improvements to the built environment, she said.
"If you build it for 80, it works for eight. If you build it for eight, it doesn't work so well for 80."
The World Health Organization developed the Age-Friendly Cities project several years ago to get planners thinking about the elements needed in a community to support healthy aging. The Public Health Agency of Canada has developed a guide for healthy aging in rural and remote communities, and its website includes a checklist of age-friendly features for outdoor spaces and buildings, transportation, housing, social inclusion and participation.
This week in St. John's, N.L., researchers will be contacting approximately 350 households for a telephone survey on the topic.
"Our research team is very much interested in systematically collecting data on the features of St. John's. What are the impressions of residents of St. John's, of housing and transportation and all the features, and then asking residents for suggestions, their impressions, on what could be improved and what city council could do about that," said Wendy Young, who holds a Canada Research Chair in Healthy Aging at Memorial University.
When sidewalks are relatively smooth and bump free — and clear of wet leaves in the fall or snow in the wintertime — it contributes to making the community livable.
"If you have a sidewalk that's well maintained, that is not only good for anybody with mobility issues, it's also good for older adults, all older adults, it's good for moms with strollers, it's good for anybody in a wheelchair," Young said.
An older adult on her research team who volunteers his time by driving people to different places is also urging that more support be given to volunteers who want to get out and remain socially active.
In Vancouver, Sims-Gould said the symposium didn't just hear about the timing of crosswalk signals, and the quality of lighting, curb ramps and sidewalks. The absence of street furniture was also discussed.
"For example in the west end of Vancouver there are a number of seniors' centres, but seniors may or may not be able to walk to them because there are some slopes," she said. "But if there were some carefully placed benches, they may indeed be able to get out and walk, knowing that there's a place where they can rest partway between."
Having a place to go — a destination such as a community centre with interesting programs — is also key. And vibrant neighbourhoods make a difference too.
The researchers heard about a woman who lives in what would be considered a safe and affluent area.
"But she doesn't like to go out and walk because it's very residential and there are no eyes on the street," said Sims-Gould. "So while the sidewalks are terrific, and it's considered to be a safe neighbourhood there's nobody around if she were to fall, if she were to have some kind of an issue. So that's a real barrier for her."
Another dominant theme had to do with nature's call.
"Some of the women spoke quite candidly about their struggles with incontinence and the need to be nearby a bathroom, and how that's created some social isolation for them," said Sims-Gould.
VanDusen Botanical Garden in Vancouver recently added washrooms throughout the park and now it's a great place for older people to visit, she said.
Where such facilities are lacking, the symposium explored the idea of the private sector getting more involved.
"If businesses could identify themselves as a user-friendly washroom, we could almost have our washrooms mapped in the city, if you will, so older adults might know that, you know, this coffee shop here has a bathroom, you don't have to buy a coffee, but you can go in and use it, for example."
However, she conceded that business owners weren't involved in this particular conversation, and the idea is somewhat controversial.