Background In the context of ageing populations worldwide, increasing numbers of older people are lonely, isolated and excluded, with serious implications for their health, cognitive and physical functioning. Access to good public transport can improve mobility, access to services and social participation among older adults. Policies that improve access and encourage the use of public transport are therefore potentially important in promoting healthy and successful ageing. Concessionary travel schemes for older people are in place in many countries but are under threat following the global financial crisis. Evidence regarding the success of these schemes in increasing activity and social participation is generally positive but based largely on qualitative or observational associations. In particular, robust evaluations of the schemes are limited by the lack of appropriate comparison groups as they generally represent a universal benefit.
Methods We use changes to the English statutory concessionary travel scheme over time, in particular the rising eligibility age from 2010 onwards, as a natural experiment to explore its impact on older people’s travel. A difference-in-difference-in-difference analysis of the annual National Travel Surveys (2002–2016) compares three age groups differentially affected by the eligibility criteria: (i) those aged 50–59 years who were never eligible for the scheme (N~2,500 per year); (ii) those aged 60–64 years who were decreasingly eligible for the scheme from 2010 onwards (N~1,000 per year); and (iii) those aged 65–74 years who were consistently eligible for the scheme throughout the period of interest (N~2,000 per year).
Results Compared with 50–59 year-olds, bus travel among 60–74 year-olds increased year-on-year from 2002 to 2010, particularly from 2006 when the scheme offered free travel. The frequency of bus travel in both the older groups then fell following rises in eligibility age (annual change in the proportion traveling by bus at least weekly: -2.9% (-4.1%, -1.7%) in 60–64 and 65–74 compared with 50–59 year-olds). Results were consistent across gender, occupation and urban/rurality.
Conclusion Our results indicate that access to, specifically, free travel increases bus use and access to services among older people, potentially improving mobility, social participation and health. However, the rising eligibility age in England has led to a reduction in bus travel in older people, including those not directly affected by the change, demonstrating that the positive impact of the concession goes beyond those who are eligible. Future work should explore the cost/benefit trade-off of this and similar schemes worldwide.
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