Left Behind:Transportation Problems of the Elderly

Living in Disappearing Rural Communities

Scott R. FalbIowa Department of Transportation

Session 1230th International Traffic Records Forum

Nashville, TennesseeJuly 26, 2004

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.

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!

Census Data for IowansOver Age 65

Census Iowans Percent Year Over 65 Change1970 350,293 1980 387,584 9.62%1990 426,106 9.04%2000 436,213 2.32%

Woods & Poole Population Projection2002 State Profile, Iowa

Projection Iowans Percent Year Over 65 Change

2005 429,800 -1.49%2015 482,190 10.87%2025 620,840 22.33%

Census Data with the Woods & Poole Projections

Older Iowans Age 65 +

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

1970 1980 1990 2000 2005 2015 2025

Census Population Projected Population

Iow

ans

Older Drivers in Iowa

149,960 156,610

198,757 192,642

63,129

101,155109,473

153,488

0

50,000

100,000

150,000

200,000

250,000

1973 1982 1990 2000

Years

Driv

ers

65-74 Year Old Drivers 75 Year Old and Older Drivers

Comparison of Older Iowan & Older Iowa Driver Projections at 80% Peak

-

100,000

200,000

300,000

400,000

500,000

600,000

700,000

1970 1980 1990 2000 2005 2015 2025

Older Iowans Age 65 +Older Drivers Age 65 +

Older Iowan Projections 87%

-

100,000

200,000

300,000

400,000

500,000

600,000

700,000

1970 1980 1990 2000 2005 2015 2025

Years

Older Iowans Age 65 +Older Drivers Age 65 +

Percentage of Drivers by Age1973-2000

Driver 1973* 1975 1982** 1985 1990 1995 2000Ages Percent Percent Percent Percent Percent Percent Percent14-24 24.4% 23.2% 23.6% 21.3% 17.6% 18.1% 18.2%25-34 19.9% 21.3% 23.0% 22.4% 21.1% 17.1% 15.9%35-44 15.2% 14.9% 15.7% 17.2% 20.1% 20.3% 19.6%45-54 15.5% 14.9% 12.5% 12.5% 13.5% 16.7% 18.1%55-64 13.1% 13.1% 12.2% 12.3% 11.7% 11.2% 11.7%65-74 8.4% 8.7% 7.9% 9.5% 10.3% 9.6% 9.2%75+ 3.5% 3.9% 5.1% 4.8% 5.7% 7.0% 7.3%

Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%Data in yellow box represent the age group with the largest percent of licensed drivers.

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.

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.

Lyon

Sioux

Plymouth

Osceola

O'Brien

Cherokee Buena Vista

Clay

Dickinson Emmet

Palo Alto

Pocahontas Humboldt

Kossuth Winnebago

Hancock

Wright

Worth

Cerro Gordo

Franklin Butler

Floyd

Mitchell Howard

Chickasaw

Bremer

Fayette

Winneshiek Allamakee

Clayton

DelawareBuchananBlack Hawk

GrundyHardinHamilton

WebsterCalhounSacIdaWoodbury

Monona Crawford Carroll Greene Boone Story MarshallTama Benton Linn

J ohnsonIowaPoweshiekJ asperPolkDallasGuthrieAudubonShelbyHarrison

Dubuque

Jackson

Clinton

Scott

Muscatine

Louisa

Washington

J efferson

Van BurenDavis

Wapello

MahaskaMarion

Monroe

AppanooseWayne

Lucas

Warren

Clarke

DecaturRinggold

Union

MadisonAdair

Adams

TaylorPage

Montgomery

CassPottawattamie

Mills

Fremont

Keokuk

Des Moines

Lee

Henry

Cedar

J ones

34.4

36.0

38.6

36.4

35.1

37.9

40.1

43.2

41.9

41.8

41.9

41.640.2

40.4

41.6

42.440.538.9

36.5

38.1

41.2

38.1

32.8

37.8

34.2

43.0 38.2

41.5

41.7

40.7

39.7 43.3

39.4

36.4

42.1

38.7 41.0

42.4

42.5

40.7

39.6

41.3

37.7

38.6 26.5

39.1

41.4

39.7

39.8 40.7

39.3

41.3

40.6

40.6

40.3

41.3

40.8

38.639.1

34.4

38.1

39.7

39.535.7

39.4

36.4

37.2 35.2

37.1

40.2

39.7

36.5

38.539.1

38.2

39.2

35.4

36.1

35.9

38.9

39.5

37.1

28.4

38.8

38.8

40.0

41.1

40.838.5

39.2

37.2

38.438.5

37.2

39.7

40.643.0

39.9

41.3

07/23/04

M e d ian Ag e o f R e s id e nts o f I o w a C o u n ties2 0 0 0

20-29.930-34.9

35-37.9

38-40.941-42.943+

L yo n

S io ux

P lym outh

O sc e ola

O 'B rien

C hero ke e B uena V is ta

C lay

D ickinso n E m m et

Pa lo A lto

Po c a ho ntas H um bold t

Koss uth Winneb ago

H a nc oc k

Wright

Worth

C erro G o rdo

Franklin B utler

Floyd

Mitche ll H o ward

C hickasaw

B rem er

Faye tte

Winnes hiek A llam akee

C layton

D elaw areB uchananB lack H aw k

G rund yH a rdinH a milton

W ebsterC alho unS acIdaWoodbury

Monona C raw fo rd C arro ll G reene B o one Story Marsha llTam a B ento n L inn

J ohnsonPo we shiekJ as perPo lkD allasG uthrieA udub onS helbyH a rriso n

D ubuque

J ac kso n

C linton

S c ott

Mus c atine

L ouisa

W ashington

J efferso n

Van B urenD avis

Wapello

MahaskaMario n

Monroe

A ppa no oseWayne

L uc as

Warre n

C larke

D ec aturR inggold

U nion

Madis onA da ir

A dams

Taylo rPage

Montgo m ery

C assPo ttaw attam ie

Mills

Frem ont

Ke okuk

D es Mo ines

L ee

H e nry

C eda r

J ones

2000

2000

1900

1900

2000

1900

1900

1900

1900

1900

1900

19001930

1900

1900

190019001900

2000

1900

1900

1920

2000

2000

1960

1940 1900

1900

1940

1940

1940 2000

1980

1960

1930

1960 1900

1900

1940

1940

1960

1940

1970

1920 2000

1930

1920

1940

1940 1920

1960

1930

1920

1900

1950

1940

1920

19801900

1980

1980

1900

19001880

1900

1980

2000 2000

1900

1880

1880

1980

19001880

1980

1870

1980

2000

1900

1970

1960

1870

2000

1900

1900

1900

1870

18701880

1950

1900

19202000

2000

1910

19201900

1900

1940

07 /23/04

C e n s u s Y e a r o f H i g h e s t P o p u l a t i o n

Before 1990 1951 - 19801901 - 1920 1981 - 19901921 - 1950 1991 - 2000

Lyon

Sioux

Plymouth

Osceola

O'Brien

Cherokee Buena Vista

Clay

Dickinson Emmet

Palo Alto

Pocahontas Humboldt

Kossuth Winnebago

Hancock

Wright

Worth

Cerro Gordo

Franklin Butler

Floyd

Mitchell Howard

Chickasaw

Bremer

Fayette

Winneshiek Allamakee

Clayton

DelawareBuchananBlack Hawk

GrundyHardinHamilton

WebsterCalhounSacIdaWoodbury

Monona Crawford Carroll Greene Boone Story MarshallTama Benton Linn

J ohnsonIowaPoweshiekJ asperPolkDallasGuthrieAudubonShelbyHarrison

Dubuque

Jackson

Clinton

Scott

Muscatine

Louisa

Washington

J efferson

Van BurenDavis

Wapello

MahaskaMarion

Monroe

AppanooseWayne

Lucas

Warren

Clarke

DecaturRinggold

Union

MadisonAdair

Adams

TaylorPage

Montgomery

CassPottawattamie

Mills

Fremont

Keokuk

Des Moines

Lee

Henry

Cedar

J ones

405.6%

225.0%

n/a

n/a

240.0%

133.3%

66.7%

n/a

28.6%

n/a

n/a

25.0%125.0%

100.0%

120.0%

66.7%57.1%0.0%

55.0%

-16.7%

28.6%

100.0%

58.3%

40.0%

155.0%

0.0% 50.0%

75.0%

25.0%

33.3%

20.0% 160.0%

50.0%

70.0%

22.2%

70.0% 0.0%

-10.0%

33.3%

33.3%

166.7%

60.0%

177.8%

200.0% 137.5%

66.7%

37.5%

57.1%

125.0% 50.0%

220.0%

175.0%

100.0%

0.0%

33.3%

-10.0%

28.6%

133.3%44.4%

156.0%

100.0%

42.9%

0.0%33.3%

50.0%

200.0%

25.0% 196.6%

-14.3%

44.4%

16.7%

145.5%

120.0%71.4%

200.0%

0.0%

190.9%

250.0%

75.0%

122.2%

125.0%

160.0%

277.8%

44.4%

40.0%

-10.0%

200.0%

33.3%n/a

100.0%

60.0%

57.1%90.9%

116.7%

0.0%

250.0%133.3%

33.3%

-33.3%

07/23/04

S av ing s In stitu tio ns i n Io w aP e r c e n t C h a n g e 1 9 8 2 - 1 9 9 7

Decrea se in the number of banks 0.0%-99 .9% increase in banks 100% - 189.9% increase in banks 190.0% or more increase in banks

Lyon

Sioux

Plymouth

Osceola

O'Brien

Cherokee Buena Vista

Clay

Dickinson Emmet

Palo Alto

Poc ahontas Humboldt

Kossuth Winnebago

Hancock

Wright

Worth

Cerro Gordo

Franklin Butler

Floyd

Mitchell Howard

Chickasaw

Bremer

Fayette

Winneshiek Allamakee

Clayton

DelawareBuchananBlack Hawk

GrundyHardinHamilton

WebsterCalhounSacIdaWoodbury

Monona Crawford Carroll Greene Boone Story MarshallTama Benton Linn

J ohnsonIowaPoweshiekJ asperPolkDallasGuthrieAudubonShelbyHarrison

Dubuque

Jackson

Clinton

Scott

Muscatine

Louisa

Washington

J efferson

Van BurenDavis

Wapello

MahaskaMarion

Monroe

AppanooseWayne

Lucas

Warren

Clarke

DecaturRinggold

Union

MadisonAdair

Adams

TaylorPage

Montgomery

CassPottawattamie

Mills

Fremont

Keokuk

Des Moines

Lee

Henry

Cedar

Jones

-9.2%

10.0%

-25.0%

-60.0%

-18.2%

-50.0%

60.0%

n/a

-63.6%

0.0%

n/a

-42.9%-60.0%

-22.2%

-23.1%

-40.0%57.1%7.7%

-22.0%

-14.3%

-30.0%

114.3%

37.5%

-42.9%

-20.0%

0.0% -7.1%

33.3%

0.0%

-15.4%

-50.0% 37.5%

57.1%

10.0%

-27.3%

-34.8% 14.3%

0.0%

-86.0%

0.0%

25.0%

-18.2%

-17.9%

-25.0% -47.9%

-18.2%

-16.7%

0.0%

0.0% 16.7%

-43.5%

0.0%

-35.7%

-25.0%

-9.1%

-50.0%

-10.0%

-23.5%-14.3%

-14.5%

-38.5%

-27.3%

-22.2%-28.6%

-15.0%

-27.3%

-33.3% -15.9%

-18.2%

0.0%

-20.0%

-2.8%

-53.8%-21.4%

-33.3%

-7.7%

-7.7%

5.9%

-20.0%

-7.4%

-18.5%

62.5%

53.6%

33.3%

-45.5%

-11.1%

-12.5%

33.3%0.0%

-26.3%

-27.3%

20.0%5.3%

25.0%

50.0%

0.0%-33.3%

-20.0%

-50.0%

07/23/04

G ro c ery S to r e s I n Io w a C o u n tie sP e r c e n t C h a n g e 1 9 8 2 - 1 9 9 7

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.

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.

Percentage of Drivers Age 65 & Older by County in Iowa

National Fatality Rates by Driver Age

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

6.87%7.39%

10.27%

14.11%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

FTYROW from Stop Sign

Under 4545 - 6465 - 7475 and Older

FTYROW Making Left Turn

6.09% 6.34%7.70%

10.52%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

Under 45 45 - 64 65 - 74 75 andOlder

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.

0.59%0.66%

0.86%

1.10%

0.00%

0.20%

0.40%

0.60%

0.80%

1.00%

1.20%

Under 45 45 - 64 65 - 74 75 and Older

Fatalities

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.

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.

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.

Questions?

Scott R. FalbResearch & Statistical Analysis

Office of Driver ServicesIowa Department of Transportation

Phone: 515-237-3154Email: scott.falb@dot.state.ia.us