Age-Related Deficits in Mobility Resilience With an Extreme Weather and Climate Event

Abstract

IMPORTANCE Mobility, defined as the ability to move freely, decreases with increasing age. The increasing frequency and intensity of extreme weather and climate events (EWCEs), such as hurricanes, pose a considerable risk for older adults (aged ≥65 years) to maintain their mobility (ie, mobility resilience). OBJECTIVE To examine whether an association exists between older-aged neighborhoods and mobility resilience following an EWCE. DESIGN, SETTING, AND PARTICIPANTS This case series study used 2022 demographics with prospectively observed social infrastructure point-of-interest visitations before and after Hurricane Ian (September 23-30, 2022) to characterize neighborhood mobility resilience. Analyses were conducted for all residents (age categories, <36 years, 36-42 years, 43-53 years, >53 years) of central and southern Florida neighborhoods. MAIN OUTCOMES AND MEASURES Using a resilience triangle framework, daily point-of-interest visitation data before, during, and after the event were used to measure the duration of recovery, ratio of recovery, ratio of impact, and area of resilience triangles. RESULTS Among 1819 neighborhoods including 8 084 335 residents (median [range] of neighborhood ages, 46 [19-82] years; 51% female), a total of 225 218 social infrastructure points of interest with 75.4 million visitation records were included. Compared with younger-aged neighborhoods, neighborhoods in the oldest age quartile had a longer duration of mobility recovery after Hurricane Ian (1.137 days; 95% CI, 0.844-1.431 days), lower mobility recovery ratio (−2.1%; 95% CI, −4.0% to −0.2%), higher ratio of impact (1.2%; 95% CI, 0.3%-2.1%), and higher cumulative losses of daily mobility (17.0 percentage-days; 95% CI, 8.4-26.3 percentage-days). These associations were substantially attenuated by hurricane wind exposure (ie, the strength of the storm) (Lindemann, Merenda, and Gold relative importance, 0.919-0.960 vs 0.031-0.065 for age quartiles). CONCLUSIONS AND RELEVANCE In this case series study, neighborhoods with an older population showed compromised mobility resilience associated with the aftermath of Hurricane Ian. These findings may inform neighborhood-targeted mobility interventions for climate resilience.