Women are more likely than men to experience mobility limitations that could benefit from the use of mobility aids but are much less likely to use them when needed, according to a new study from researchers at UCL and the London School of Hygiene and Tropical Medicine (LSHTM).
Though the prevalence of disability continues to rise among the over fifties, many people do not have access to the mobility aids - such as canes, walkers, or wheelchairs - that are essential for maintaining independence and social engagement1.
Published in The Lancet Public Health, the study explored which demographics might be more or less likely to use mobility aids when they would benefit from them.
The team analysed survey responses from 12,080 participants aged 50-89 over 13 years (2006-2019), using data from the English Longitudinal Study of Ageing.
During that time, 8,432 participants reported having some mobility difficulty. Of these, 5,102 (61%) experienced unmet need at least once (not using a mobility aid despite experiencing difficulty), while 3,330 (39%) reported using a mobility aid at least once.
Women were 50% more likely than men to transition from not needing a mobility aid to unmet need status during the study period, but were 20% less likely to transition from unmet need to use.
The authors of the research say this highlights a gender inequality that needs to be addressed to improve an overlooked area of public health.
Jamie Danemayer, first author of the study from UCL Computer Science and UCL's Global Disability Innovation Hub, said: "Though unmet need for mobility aids like walking sticks and wheelchairs is a prevalent global health issue, it's unclear how non-clinical characteristics like age, gender, or socioeconomic position might make people more likely to experience unmet need.
"Our analysis suggests that there is a clear gender gap in access to mobility aids. Though our data didn't ascertain the reason why participants weren't using mobility aids, other research tells us that women are often more likely than men to face obstacles such as cost barriers as a result of well-documented income disparities between genders.
"Many mobility aids are designed for men rather than women, which we think may be a factor. Using mobility aids can also make a disability visible, which can impact the safety and stigma experienced by women in particular. There's a critical need for further research to identify and break down the barriers preventing women from accessing mobility aids that would improve their quality of life."
The study also documented other demographic factors associated with a higher likelihood of needing a mobility aid, including lower educational attainment, unemployment or disability, and lower wealth. However, these demographics were also more likely to use mobility aids if they needed one, further underlining that gender is a key determinant of unmet need.
Previous research from the UCL Global Disability Innovation Hub found cost is the biggest barrier to mobility aid use for both genders.
Professor Cathy Holloway, an author of the study from UCL Computer Science and UCL's Global Disability Innovation Hub, said: "Not having access to mobility aids when a person needs one can have a big impact on their independence, well-being and quality of life. Our analysis suggests that women in particular, regardless of other factors such as education and employment status, are not getting the support that they need.
"I expect that the reasons why women are less likely than men to use mobility aids if they need one are numerous and the overall picture is probably complex. Further research in this area would help to identify where barriers can be removed."
Professor Shereen Hussein, senior author of the study and lead of the Social Care Group at the London School of Hygiene & Tropical Medicine, said: "This study underscores the critical need to address gender disparities in access to mobility aids, a vital yet often overlooked component of public health and disability inclusion.
"The research provides compelling evidence of gender disparities in accessing assistive technology, suggesting that cost, design bias, and social stigma are likely to disproportionally affect women. This underscores the need for inclusive, gender-sensitive approaches in the design, production and inclusivity of assistive technologies. These insights offer a valuable foundation for national and global policymakers to prioritise gender equity in ageing and disability policy developments."
This study was funded by UK Aid as part of the Global Disability Innovation Hub's AT2030 programme.
1 The full list of mobility aids included in the survey was: a buggy or scooter; a cane or walking stick; a Zimmer frame or walker; a manual wheelchair; an electric wheelchair; or elbow crutches.
Participants were considered to have a lower mobility limitation and mobility aid need if they reported difficulty with one or more of the following mobility activities: walking 100 yards, climbing a flight of stairs without resting, kneeling or crouching, and/or getting up from a chair after sitting for long periods of time.
