Walkability in aging Japan: Challenges for age-friendly design and health behavior change in urban Tokyo

Abstract

Introduction The Tokyo-Yokohama mega-city is confronting the twin challenges of demographic aging and urbanization. As Tokyo ages, more attention is required to evaluate and improve urban walkability, which is a key World Health Organization indicator of age-friendliness that supports physical activity and social participation. Objective This research aimed to systematically assess walkability in 10 super-aged neighborhoods across two growing cities in west Tokyo. Methods This mixed methods research incorporated population surveys, systematic walking audits, and streetscape photography. Assessment of walking behavior was undertaken among 1200 Tokyo residents aged 65 and older using the International Physical Activity Questionnaire. Walking audits of 10 super-aged neighborhoods in the Musashino and Mitaka were undertaken using the Microscale Audit of Pedestrian Streetscapes tool and a team of trained auditors. Audits charted the journey from older-adult housing to four typical walking destinations within 400m. Results In Tokyo, 30% of older adults are physically inactive and walking behavior has declined by up to 13% since the beginning of the COVID-19 pandemic. Walking audits of super-aged neighborhoods revealed statistically significant variations in urban conditions, with all locations scoring in poor-to-fair ranges in relation to international reference values. Prevailing challenges included discontiguous pedestrian infrastructure, limited traffic calming measures, trip hazards, land use constraints, and a lack of supportive urban amenities. Conclusion Implications for age-friendly planning will be discussed to inform targeted remediation of urban walking conditions for aging residents. The utility of grounded observational methods will also be addressed for elucidating interactions between aging, urban environment, and walking behavior.