Monday, March 31, 2025

Mobility Equals Freedom, Part 2: Driving and Quality of Life


“Everything in life is somewhere else—and you get there in a car.”  -- E.B. White

“Twentieth-century urban America didn’t belong to the skyscraper; it belonged to the car.  Transportation technologies have always determined urban form.”

– Edward Glaeser, Triumph of the City (2011)

 

The following are factors that diminish quality of life as listed in the Pennsylvania Advance Health Care Directive.  The lead question is this: “When you think about the following scenarios, what would be considered an unacceptable quality of life?”

  A person driving a car

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Not being able to drive a car                 

A bed with a lamp on the side of the bed

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Not being able to get out of bed

A white house with a white picket fence

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Not being able to leave the house or move around and interact with people (e.g., a coma state)    

A close-up of a person's hands

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 Not being able to have meaningful relationships or recognize family or friends

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Not being able to think for myself or make my own decisions

In other words, not being able to drive is incompatible with quality of life: If I can’t drive, living is no longer worthwhile.   Losing the driving license is the lead-in to a dependent life.  And for Americans, loss of independent mobility equates to a severely compromised state of being. 

The way people move around, and for what reasons, has much to say about opportunity.  How that opportunity is recognized and acted upon, in turn, provides clues about what cultural values are, how they act as deep motives, and how change is seen - as enhancing or blocking the top operating values.  The ability to drive is considered the gateway to many opportunities, and especially to the ability to hold a job—even with remote work as an option. 

In the US, staying put is not regarded as advantageous to individual development.  We all know that to progress, go to a decent school, build a career, get a family started, meet partners and leverage relationships, use marriage as a driver of social capital, we have to seek out new places.  Our country was founded on these tenets as Europe looked west to the new world to realize freedoms not to be found in locked-in Old World centers. 

License to move

The driver’s license is a rite of passage in the US, marking the start of true independence away from the family and obligations to parents.  Independence is the American measure of mental and physical well-being, and also, in a seeming contradiction, the basis for social health and upward mobility.  Independence is a signal of intelligence and social viability through mobility, and the car provides that most effectively.  

What about public transit?  Five percent or less of the American public use commuter trains and buses; even Washington D.C.’s excellent Metro system has just a 10% ridership.  High usage correlates with population density, as in Japan, Hong Kong, New York City, and much of Europe. Edward Glaeser estimates that commutes by public transit are twice that of cars, 48 minutes against 24 minutes, which is why 86% of US commuters opt for the time-saving route.  He gauges the best commute as the brief walk of 15 minutes, less than a mile (Triumph of the City, p. 13).  The time burden is independent of actual distance: “The problem with public transportation is the time involved in getting to the bus or subway stop, waiting to be picked up, and then getting from the final stop to one’s ultimate destination” (179).    

In between is the hybrid of semi-private car services such as Uber and Lyft and vans powered by smart phones at rates closer to taxis than buses.  For most middle-class Americans—and 95% call ourselves middle-class—the price of public transit is not the ticket but the stress of riding with below-middle classes than we’d like to see around us.  In Honolulu, with one of the leading bus systems island-wide, class-mixing is less an issue in the nation’s most diverse state with more equal incomes, but tourists still favor car rentals.  Wills Eye Hospital, in its literature on “Preparing for Hospital Discharge,” warns that “Public transport is not an acceptable form of transportation home from the hospital.”  You need access to a private car and driver just to return home from your treatment.

Mass transit leaves the rider dependent on schedules and stop locations, going against the autonomy principle that one should be able to go wherever and whenever they want, one of our leading cultural core values.  The need to live by someone else’s schedule, often requiring transfers to other parts of the routing, takes a toll on the rider’s time, and this is the core of the problem.  Even waiting in traffic is seen as an acceptable exchange for the ability to travel point to point once the blockage clears.  It is the main advantage of an Uber ride. 

Since Ford’s Model A, cars took off, making the ability to travel long distances the hallmark of the free life.  The driver’s license is the turning point for adolescents into independence and autonomy.  Car ownership makes independence possible.  One car per family of two employed adults is considered a disabled system, just waiting to finance the second car.  Losing that license is the start-point of life’s end, giving up independence to rely on the wheels of others.  For these nondrivers, a city’s dependence on cars is the leading factor for livability.  Los Angles is famous as its own car culture, because of the far-spread geography, but Florida is just as car-centric, as are Seattle and Washington, DC., and even the sprawling Las Vegas strip.   

Quality of life   

In summary, the Pennsylvania’s Advance Health Care Directive (above) features a listing of quality-of-life factors (quality of life being a major measure of wellness in medicine).  Each factor is to be checked only if it is a deal-breaker in end-of-life quality so that the Power of Attorney can see what the patient has determined he/she can’t tolerate.  The list includes: “Not being able to move around and interact with people (such as in a coma)”; “Not being able to think for myself or make my own decisions”; “Living in a nursing home”; “Living in constant severe pain,” or--wait for it-- “Not being able to drive a car.” 

This is in line with other measures of life quality.  The Americans with Disabilities Act (ADA) qualifies inability to drive for medical reasons as a disability if it limits performing a major life activity, such as working or engaging in daily tasks.  For a broad class of jobs (including driving itself), driving is a major life activity.  The largest class of male workers are those employed in driving activities.

The car question is the only item on the list of 13 that is not a medical issue, including “Not being able to live on my own.”  And, in deference to the American bias toward independence, “being able to live on my own” is the last right the aging population is willing to give up, the strong bias being independence, as in "aging in place."  In many cultures, this would be a highly unwanted state of things--being unable to live with relatives would be the non-starter.  For Americans, NOT living alone and not driving to and from that home are the deal-breakers.  But before independent living, independent driving takes first place in defining quality of life.  Even teens of driving age can create a world of their own away from the family home.

In a world increasingly urban and densely populated, and in the face of climate change, the power of the automobile to dictate mobility and housing options is coming under increasing pressure to resolve the issues of cultural values: autonomy and independence.  Already these issues are showing high costs to society as well as the individual.  What eventual solutions can be devised to resolve the pragmatic costs that threaten our embedded beliefs?


* Images from KODA, Pennsylvania Advance Health Care Directive (2024)