Without a Ride: COVID-19 vaccination exposes gaps in transportation for older adults

Tammy Bui (she/her) is a 2021 Social Connectedness Fellow working with HelpAge Canada. Tammy is an MSc. Public Health graduate at McGill. She grew up in Ottawa, Ontario. Tammy completed her bachelors degree at the University of Ottawa in Biomedical Sciences which ignited her passion for work in aging and health inequalities. Her current Master’s research focuses on reducing the inequalities faced by older adults at a population level and she hopes to make a difference through policy action and community-level change. Tammy is interested in the intersection between aging, health services, and health policy. She aspires to be at the forefront of gerontological health research by pursuing a PhD in this field.

Canada is making strides towards COVID-19 vaccination coverage, with 71.5% of the total Canadian population already having received their first dose. In Quebec, we are seeing vaccination numbers soar, surpassing the Canadian average with 75% of the Quebec population receiving their first dose as of August 2021.  

Despite the sheer mass of Quebecers getting vaccinated, and the age-targeted vaccine roll-out, some older adults bore the brunt of the crisis. Vaccinating older adults first was prioritized back in February, however, many older adults in Montreal claimed basic access to vaccines was thwarted due to poor access to public transportation: 

Alex Leduc, of CBC, highlighted some of these accessibility issues: “Several of the mass vaccination centres are difficult to reach by public transit… Decarie Square in the community of Côte-Saint-Luc, which pedestrians must cross a highway to get to from the nearby Metro station.”

Advocates have also expressed concern that Quebec’s mass vaccination plan failed to consider older adults with reduced mobility.

This problem is not just unique to Montreal. Similar concerns have been echoed across many densely populated cities across Canada, including by older adults in Toronto and in Calgary. With talks of a third potential booster vaccine, Montreal needs to take into consideration how our transportation could be more accessible, available, and appropriate for older adults. 

Adequate public transportation has been the dominant logistical challenge facing Montreal older adults for some time, but COVID-19 vaccine efforts have shed light on the true depth of inequities in older adults’ transportation. Montreal’s topography is hilly and complex. Hilly terrain, in combination with winter sleet and slippery ice, made it extremely challenging for older adults to walk outside safely back in February 2021. Without proper age-friendly transportation in place, the city’s most vulnerable, such as older adults with limited mobility, had little chance at getting their shot. 

No vaccine means older adults were forced to stay at home alone and isolated for longer than intended – perpetuating the likelihood of loneliness and social isolation. Social isolation and loneliness are detrimental to older adults’ health and well-being. Canadian studies show that among older adults, 30% are at greater risk of social isolation, and 16% often feel isolated from others. These numbers were exacerbated due to the pandemic. 

The COVID-19 vaccine roll-out uncovered many gaps in older adults’ transportation across the city. Some may even question, “What is the point of equitable age-based roll-out of a vaccine when inequitable transportation exists as the primary barrier to get to the vaccination site in the first place?” Currently, the Montreal older adults transportation landscape is inaccessible, inequitable, and outdated. 

We need sustainable transportation solutions to not only improve access to healthcare, but to also improve older adults’ mobility for the long-term. 

There have been interesting and innovative solutions in the US to help older adults access vaccines during the pandemic. For example, Toyota, in partnership with the American Association of Retired Persons, provides free rides for persons over 50, planning a vaccine appointment called Ride@50+. Ride@50+ is at the cutting edge of senior’s transportation – offering multimodal ride-sourcing, flexible ride-booking options and even hosting a community leadership circle to understand the mobility needs of older adults. Through inclusive approaches, Ride@50+ has effectively removed barriers to accessing vaccines by providing tailored age-friendly transportation. 

We have a part to play in addressing the inequitable barriers to access transportation so that older adults have the means to empower themselves to participate equally. We urge advocacy organizations in Montreal to collaborate, form multi-sector partnerships to provide transportation solutions that are independent of public transport. Transport providers should also include older adults in the co-creation of the transportation solution to fully capture the needs for accessibility.  Since current transport solutions are unable to meet the demands of the aging population, Montreal needs to be responsive to this clear threat to older adults’ health, safety, and social connectedness.

Revolutionizing older adult transportation has direct benefits for older adults to maintain independence, autonomy, and social connectedness for our aging population. The benefits to inclusive travel options results in secondary benefits like comfortable travel for tourists, improved social equity and economic opportunities.