Last week Québec’s automobile insurance agency, the SAAQ, introduced a new rule: henceforth, any person diagnosed with neuro-cognitive impairement will have their driving license revoked.
This will have a major impact – especially on elderly people, many of whom are, understandably, concerned about this threat.
I have just listened to an insightful interview in which Ms. Mélanie Cadrin mentions the terrible repercussions (upon her and her family) of an accident caused in 2010 by an elderly person who really shouldn’t have been driving. Ms.Cadrin is lucid and generous, as well as being pro-active and forward-looking: the interview (in French) is worth listening to.
Interestingly, she makes a key link between the new SAAQ policy and urban planning, which I elaborate on below.
Withdrawing licenses and urban planning: equity, inclusion and safety
North American cities – and many cities across the world – are simply not designed for people who can’t drive.
Not only are they low-density and essentially suburban, but social, family, leisure, and economic activities occur at city-wide (or wider) scales. Driving is crucial to maintain social contacts: depriving someone of their license, whilst a sensible safety measure for themselves and others, condemns them to isolation (not to mention loss of liberty and freedom, which are associated by many people, and by our wider culture, with the capacity to drive).
Thus, the design of cities, and more generally our current settlement pattern, are directly connected with the discomfort and fear that the SAAQ’s policy is generating amongst the elderly (and other people who live with neuro-cognitive impairements).
The SAAQ’s sensible and necessary rule raises important issues of equity, of inclusion, of individual v. collective rights, and of ageism: for the greater good of safe roads, the freedom and social lives of vulnerable, often elderly, people are being curtailed. The rule itself is not ageist or inequitable, but it has these consequences given the context.
The distinction between necessary rules and their impacts (given the context) is important to urban planning, to anyone concerned with equity and inclusion, and should directly feed into the way we think about, and design for, cities and mobility.
Bikes and buses aren’t enough
Let them cycle! After all, Marie-Antoinette suggested that starving peasants should eat cake (since they had no bread)… why can’t everyone just forgo the automobile!
The problem is that active and public transport are well-adapted to people who are not living with any physical or cognitive impairement (and who do not need to cover large distances or carry heavy loads). Many urban planners understandably advocate them – sometimes with such enthusiasm (and maybe a touch of exaggeration or arrogance) that they overlook those of us who are old (or rapidly getting there), less fit, or who are living with conditions that impair physical mobility.
There is, in fact, growing critique of active transport solutions – but for the time being this critique tends to be articulated from the perspectives of race and socio-economic inequality, less from the perspective of ableism and aging.
A key point made by Ms Cadrin is that license withdrawal should be destigmatised: it needs to become a normal act, something that should be planned for, just like retirement is.
She also discusses the importance of finding mobility solutions for people who lose their license. The solution she evokes in her short interview is a community-based volunteer system, whereby older people who are good drivers make themselves available to give lifts to people less able to drive.
It takes a village to raise a child – it may also take a village to age gracefully.
Why 15 minute neighbourhoods are good, but not enough
Urban and transport planners need to fully engage in these issues: the population is aging, and more and more people will (or should) lose their driving licenses.
However, medical professionals hesitate to signal cognitive impairement of their patients to authorities because they are well aware that, in doing so, they condemn their patients to social isolation and to a dimished sense of self.
If cities, communities, and transport systems were truly adapted to people living with mobility issues – and this extends beyond the elderly and people living with neuro-cognitive impairements : parents with young children, for instance, have mobility issues! – then it would be easier for doctors to make these difficult diagnoses, easier for people to accept them, and easier for everyone to move around.
15 minute neighbourhoods (urban villages?) are one way forward, at least for day-to-day activities – but they are unlikely to allow people to meet all their social, leisure, medical and other needs.
Truly accessible public transport (for example where every metro station has an elevator, not just 21 out of 68 as in Montreal), good sidewalks (for example level, wide, obstacle-free, cleared of debris, and properly ramped…), decent crossings (for example pedestrian rather than car priority) are all important.
But so are intercity travel, access to rural areas, mobility within suburbs. These also need addressing lest neighbourhoods become traps: density and neighbourhood-level planning are only partial solutions. They are good principles to bear in mind when designing new neighbourhoods and planning regulations, but they are not a solution for retrofitting all suburbs nor for sustaining access to family, friends and open spaces beyond urban limits.
First steps: destigmatisation and immediate practical interventions
But maybe the most important first step is a wider cultural one, one we are still some way from achieving.
No longer having a driving license needs to be destigmatised and normalised. It needs to be a normal state of affairs, something that is envisaged and planned for as people age or encounter health issues – it is not punishment. Yet it will remain a form of punishment until local and wider mobilities are possible without a driving license: so immediate action is also required.
Urban planners can both participate in destigmatisation (by fully incorporating non-drivers into city and regional planning visions, at all scales) and explore immediate practical solutions for those amongst us who can no longer drive.
The two – the vision and immediate, practical, ways forward – go hand-in-hand.