摘要：Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms. A significant challenge for public health is to develop effective and efficient strategies to promote health and well-being in a growing and increasingly diverse aging population. Healthy aging , a term that is used to refer to this public health objective, is defined by the Centers for Disease Control and Prevention as the “development and maintenance of optimal physical, mental and social well-being and function in older adults.” 1 (p3) Healthy aging is likely to be achieved when physical environments and communities are safe, and support the adoption and maintenance by individuals of attitudes and behaviors known to promote health and well-being, and by the effective use of health services and community programs to prevent or minimize the impact of acute and chronic disease on function. 1 (p3) Optimal mobility , defined simply as being able to safely and reliably go where you want to go, when you want to go, and how you want to get there, is a key component of healthy aging. Mobility refers to movement in all of its forms, including basic ambulation, transferring from a bed to a chair, walking for leisure and the completion of daily tasks, engaging in activities associated with work and play, exercising, driving a car, and using various forms of public transport. Just as negative health outcomes are associated with impaired mobility, health and well-being are enhanced through strategies to optimize mobility. As evidence of the growing interest in the health effects of mobility, the American Public Health Association recently released Transportation and Health Toolkit , 2 and the Environment and Policy Change for Healthy Aging Initiative, sponsored by the Centers for Disease Control and Prevention Healthy Aging Research Network, produced Optimal Living: Getting Around . 3 Mobility has significance for research, practice, and policy in aging and public health. Walking and driving are the 2 leading forms of mobility among older adults in neighborhood settings. 4,5 Here we (1) review the public health burdens of mobility disability as well as some of the key epidemiological findings in this area, (2) identify leading public health interventions to enhance walking and driving in older populations, (3) discuss challenges and opportunities for public health action, and (4) recommend new directions for public health action, including the development of an integrated mobility agenda to guide the examination and promotion of safe walking and driving as part of the everyday lives of older adults. Although the study of mobility among institutionalized older adults is also an important area of research, it is beyond the scope of this article.
