1. Left Behind: Transportation Problems of the Elderly Living in Disappearing Rural Communities Scott R. Falb Iowa Department of Transportation Session 12 30 th International Traffic Records Forum Nashville, Tennessee July 26, 2004

2. The Undeniable Facts: We are growing older. The life span of older Iowans is growing longer. Older Iowans, on average, are staying healthy longer. Older Drivers are growing more numerous. While today’s older Iowans are healthier than people of the same age in 1950’s and 1960’s, health and driving capabilities do deteriorate. One ramification of the longer life span is an elongation of the period of decline.

3. The Unconfronted Facts: Drivers age 75 and above have grown 10.4% between 1992 and 2001 from 140,793 to 155,446. In 2000 approximately 7000 persons.,nationally, age 65 and older lost their lives in traffic crashes. In Iowa, for the same year, 89 people over age 65 were killed in traffic crashes (20% of total fatalities). Almost 3000 persons (8% of total injuries) over the age of 65 were injured in traffic crashes. The elderly make up a bigger proportion of the fatalities than the injuries!

4. Census Data for Iowans Over Age 65

5. Woods & Poole Population Projection 2002 State Profile, Iowa

6. Census Data with the Woods & Poole Projections

10. Percentage of Drivers by Age 1973-2000

11. Other Iowa Demographics The number of young people has been dropping since the 1970 census. The number of young middle age adults has been decreasing since the 1970 census. The number of young old Iowans has been increasing since the 1970 census. The number of old-old Iowans is increasing since the 1970 census.

12. Rural Iowa Demographic Dynamics Rural Counties are losing population and have been for awhile. –10% of Iowa Counties saw their highest population before 1900. –43% of Iowa Counties saw their highest population between 1900 and 1929. –23% of Iowa Counties saw their highest population between 1930 and 1969. –14 Urban or Suburban Counties are still growing and have hit their highest population to date in the 2000 census. Across the state, young people are leaving as the older population grows. In rural areas, especially, young adult family members, who traditionally provided the life blood for rural communities and the support system for the elderly are leaving for larger communities both within and outside the state.

17. Other Sociological Demographics Full-line groceries and even “mom & pop” groceries are being replaced by convenience stores with less selection and much higher prices. The number of doctors and hospitals have been decreasing in rural counties. Where clinics have stayed open in the most rural communities, doctors have been replaced by nurse practitioners. Pharmacies have been leaving small communities as aging pharmacists retire. Rural churches have had to close or consolidate between smaller communities.

18. More Sociological Demographics Over 30% of the Iowa workforce is employed in the five metropolitan counties in central Iowa. The flight of young people from rural communities and increasing worker commute distances for the few who stay have caused a staffing crisis in volunteer fire and EMS services in rural communities. Iowa has engaged in a program of converting a web of two lane state highways into four-lane, high-speed expressways in order to service Iowa’s expanding commuter work force. The more complex traffic patterns and higher speeds appear to be detrimental to Iowa’s elderly drivers.

19. Percentage of Drivers Age 65 & Older by County in Iowa

20. National Fatality Rates by Driver Age

21. Comparison of Failed-To-Yield-Right-Of-Way Crashes by Age

23. How the Elderly Fare in Traffic Crashes When the elderly are involved in crashes they are more likely to be killed. The older the person is, the lower the survivability in severe crashes. At age 75 or older motor vehicle occupants are fatally injured in one out of 90 crashes in which they are involved. Persons under the age of 65 were fatally injured in one out of every 160 crashes in which they are involved.

25. Conclusions The Iowa population is aging. Rural Counties are losing population. Rural young people who do not leave the state are moving to urban/suburban counties. 30% of Iowa’s employed work in five central Iowa counties. Retail, medical, and pharmacy businesses are following the workforce out of the most rural areas. The most rural counties have had the largest percentage of population lost.

26. Conclusions The most rural counties have the oldest median ages and the highest percentage of elderly. The most rural counties have the highest percentage of older drivers. The services and businesses the elderly depend on are being consolidated increasingly in more urban counties further away from many of Iowa’s oldest citizens. Elderly drivers have some of the highest fatality rates per mile driven making the elderly more vulnerable when they have to travel longer distances.

27. Conclusions Older drivers are more vulnerable in crashes on the higher speed roadways the elderly must use to travel to the larger communities where hospitals, doctors, pharmacies, full- line groceries, churches and social activities. Transportation alternatives disappear from the smallest communities—new county-based alternatives are hard to start as county tax revenues disappear with fleeing workforce, businesses and support services. Elderly Iowans who cannot drive or have had to give up driving end up stranded in communities that are too small to provide transportation alternatives.

28. Questions? Scott R. Falb Research & Statistical Analysis Office of Driver Services Iowa Department of Transportation Phone: 515-237-3154 Email: scott.falb@dot.state.ia.us