Background Free local bus travel is available to all people over state pension age in England via the older people’s bus pass. Recent calls to means-test the scheme have prompted policy interest in the distribution of holding the bus pass, while previous research has associated the bus pass with health benefits. We will investigate i) the socio-demographic characteristics of holders of the bus pass, ii) use of public transport amongst older people and iii) the relationship between having a bus pass and gait speed and adiposity.
Methods We used data on 4650 older people we were certain were eligible for a bus pass (aged ≥62 years) at wave 6 of the English Longitudinal Study of Ageing (ELSA). Gait speed was assessed by a timed 8 feet walk, and measures of adiposity were objectively measured Body Mass Index (BMI) and waist circumference. Analyses adjusted for age, wealth, labour market status, problems with activities of daily living, mobility problems and access to a car.
Logistic regression assessed predictors of holding a bus pass and the use of public transport at least once a month. Sex-stratified linear regression models assessed the associations of the bus pass with gait speed and adiposity.
Results Overall 86.3% of our sample had a bus pass. Bus pass holders were more likely to be female (89.1% vs. 82.9% of men, p < 0.001), retired (88.8% vs. 73.1% of those in paid work, p < 0.001) and without access to a car (94.9% vs. 85.0% of those with access to a car, p < 0.001). Bus pass holders were more likely to use public transport at least once a month than non-holders (82.2% vs. 33.2%, p < 0.001).
In fully adjusted models female bus pass holders had faster gait speed (β = 0.05, 95% Confidence Interval (CI) 0.02 to 0.09), lower mean BMI (–1.19 kg/m2, 95% CI –1.84 to –0.55) and lower mean waist circumference (–3.15 cm, 95% CI –4.69 to –1.61). These associations however, were not evident among men (e.g., –0.05 kg/m2, 95% CI –0.53 to 0.42 for BMI).
Conclusion While uptake of the bus pass is high, groups who may otherwise be at risk of social isolation are currently more likely to hold one. Those with a bus pass use public transport more frequently and have faster gait speeds and lower adiposity, in particular women. This points to potential unanticipated health benefits of the policy and should be noted when considering any alterations to the policy of free bus transport for older people.
- Older people