# The impact of slow mobility and built environment characteristics on 12.5-year all-cause mortality among older women and men: A prospective cohort study from Poland

## TL;DR

This study shows that the quality of the built environment affects the mortality risk of older adults who use slow mobility modes like walking or cycling.

## Contribution

The study identifies gender-specific built environment factors that influence mortality risk among older adults using slow mobility.

## Key findings

- Higher quality streetscapes for women and walkways for men who walk are protective against mortality.
- Bikeways are linked to lower mortality in women who cycle but higher risk in men using fast transport.
- Social participation partially mediates the relationship in unadjusted models.

## Abstract

Worldwide initiatives promoting mobility modes such as walking or cycling as low-cost and zero-emission forms of transport, have highlighted the possible health benefits of slow mobility. Identifying crucial elements of the built environment (BE) for slow mobility users, especially older adults, is important.

The study aimed to: compare the mortality risk of slow mode users with other transport mode users in both men and women; verify, which aspects of subjective and objective assessment of the BE are relevant as risk factors of 12.5-year all-cause mortality across various mobility mode users; examine social participation as a mediator of the relationship.

The Polish part of the COURAGE in Europe cross-sectional baseline study was conducted in 2011. The analysis included 1166 face-to-face interviews with randomly selected community-dwelling individuals aged 65 years or older from Poland. Information about deaths was obtained from the State Systems Department on Mar 1, 2024. The outdoor BE was assessed by trained interviewers’ direct observations. The Cox proportional hazard models were used.

Higher quality of streetscapes (in women) and walkways (in men) for those who mainly walk in their neighborhood, and bikeways (in women who cycle) were found to be significant protective factors against mortality. Walkways and bikeways were associated with a higher risk of death in the fast mode of transportation group of men. Mediation effect of social participation was found in unadjusted models.

The findings underline the importance of planning and organizing the BE from an age–friendly perspective and the need for a holistic approach to urban planning.

•Objective assessment of streetscape is a predictor of all-cause mortality in slow mobility users (in women).•Objective assessment of walkways (in men) is a predictor of all-cause mortality in slow mobility users.•Objective assessment of bikeways is a predictor of all-cause mortality in women who cycle.•Walkways and bikeways were associated with a higher risk of death in the fast mode of transportation group of men.•Mediation effects of formal or informal participation were found in unadjusted model.

Objective assessment of streetscape is a predictor of all-cause mortality in slow mobility users (in women).

•Objective assessment of walkways (in men) is a predictor of all-cause mortality in slow mobility users.

•Objective assessment of bikeways is a predictor of all-cause mortality in women who cycle.

•Walkways and bikeways were associated with a higher risk of death in the fast mode of transportation group of men.

•Mediation effects of formal or informal participation were found in unadjusted model.