Transport practices of Māori Kaumātua (Indigenous elders) in Aotearoa New Zealand: baseline findings from prospective older adults transport and health study (NZPATHS)

Abstract

Background

Transport is fundamental to support older Māori (kaumātua) wellbeing, facilitating ageing in place, social inclusion and access to cultural sites and practices – there is minimal research on transport practices of Indigenous populations and no published quantitative studies on the transport practices of kaumātua. Considering this data gap, we describe kaumātua transport practices and driving cessation planning in the context of a sample of older drivers from Aotearoa New Zealand.

Methods

Cross-sectional descriptive analysis of baseline data from New Zealand Prospective Older Adult Transport and Health Study (NZPATHS) of 1181 older drivers (65–96 years), 15% of whom identified as Māori. Data were gathered via computer assisted structured telephone interviews, including socio-demographic, health, transport and driving practice measures. Statistical tests performed were Mann Whitney, chi-square and Fisher’s exact tests, to provide contextual ethnic comparisons between categorical variables.

Results

Participants reported transport modes used in the previous three months. Similarly to non- Māori, kaumātua (driving at baseline) relied heavily on the private car for transport, as drivers (solely, 99%; or with passengers, 90%) and as passengers (87%). Compared to non-Māori, fewer Māori walked for transport (41% vs. 53%), and fewer used public transport (18% vs. 26%, bus/tram; 10% vs. 16%, train). Few kaumātua (4%) had made plans for not driving, a smaller proportion than for non-Māori (11%).

Conclusions

Kaumātua rely heavily on private cars for transport, yet when they can no longer drive, this dependence may present barriers to daily living and to maintaining cultural practices, health, and wellbeing. Increased transport infrastructure including public and community transport is needed to allow transport options beyond driving. Transport stakeholders must incorporate wider perspectives, including Indigenous peoples’ voices. This study provides data that can be used to inform and support improvements within the transport sector that reduce transport and health disadvantage and inequities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-24051-x.

Background

Aotearoa NZ’s ageing population

Aotearoa New Zealand’s (NZ) population is ageing; by 2034, more than one in five New Zealanders will be over 65 years [1]. Estimates suggest the Indigenous kaumātua (older Māori) population will more than double, from 48,500 in 2018 to 109,400 in 2034 [1]. Here we use kaumātua to refer to Māori aged 65 years and older although we recognise that in other instances kaumātua status can reflect knowledge and expertise rather than chronological age. In 1999, the eminent Māori scholar, Sir Mason Durie, warned about future generations of elderly Māori: “Unless their position is adequately considered, in advance, there is a danger that they will become a seriously disadvantaged and alienated group” (p.102) [2]. Today, a reduced life expectancy (of around seven years) is one example of persistent disparities between Māori and non-Māori [3]. Recently, Dawes et al. [4] have argued for centring the kaumātua voice to address ongoing inequities in Māori health. Our research provides quantitative data, highlighting kaumātua experiences within the transport sector.

NZ’s strategic direction for older people is focused on supporting older people to lead lives that are valued, connected and fulfilling [1]. Increasingly, policy goals include supporting people to live in their own home or community for as long as possible: to achieve “ageing in place” [5]. Furthermore, NZ’s Healthy Ageing Strategy aims for older people to have equitable access to services, ensuring older people are healthy, independent, connected and respected [6]. Both accessibility and ageing in place are aspects of older people’s wellbeing and mobility that can be mediated by transport [5, 7, 8]. Equitable access to transport options that meet the needs of the population is an important element of kaumātua wellbeing, in a country with a dispersed population across multiple regions.

Aotearoa NZ’s current transport system and context for older people

NZ’s transport system is one that is highly car dependent [9] and this dependence contributes to substantial excess health burden through traffic-related trauma, air pollution, and reduced physical activity [10]. Despite being a highly urban population, including for adults aged 65 years and older [11], adequate alternatives to driving are limited. Public transport services are challenged by accessibility and affordability issues [9, 12, 13]. Nationwide concession schemes which provide subsided transport options, including the ‘SuperGold Card’ for those 65 years and older and the Total Mobility Scheme for those with disabilities, alleviate some of the cost barriers [14, 15]. Recent research, however, identifies ongoing transport barriers for disabled persons and those with mobility issues, including the subsidised taxi fares offered under the Scheme still being prohibitively expensive (as well as unavailable in many areas due to a lack of taxis), the lack of bus and train services in many areas (and/or the inconvenience of those, or not being close enough to walk to), problems with footpaths that make walking difficult, and other concerns [14]. Areas outside of the main urban centres remain dependent on the private car with few alternate options (including public transport or private providers such as taxis) for transport.

Alongside car dependence NZ has high rates of driving licensure, and this is the case for those aged over 65 years, with 83% Māori and 88% non-Māori holding a driver’s licence in 2018 [16, 17]. Driver licence renewal, through a fitness to drive medical assessment, is required once drivers reach 80 years and then biennially, and licensure rates remain high among this ‘older’ older driver age group [18].

Transport equity and planning for transport infrastructure

Transport equity research is extensive [19] but scarce for Indigenous peoples [8, 10, 12, 19–24], including NZ’s kaumātua [12, 25]. Transport (in)equity has been defined in various ways, including: “transport disadvantage” (the “reduced availability of transport resources”); “transport justice” (“fairness in the transport system”); and “mobility justice” (“unjust power relations and uneven mobility”) (p. 12) [20]. Transport inequities are more pronounced for Māori, who potentially stand to gain more (including a reduced gap in life expectancy) than non-Māori from a transport system that prioritises active transport, accessible public transport, better urban planning and other ways of achieving an equitable transport system over the current transport policy reliance on the private car [10]. Active transport benefits include better physical and mental health, via increased exercise and social connections and the creation of more restorative environments [26].

Transport inequity is multi-layered, existing through a combination of personal, relational and structural influences “at the juncture of mobility and health” (p. 722) [8]. Across societies, transport infrastructure required for all transport modes, including roads, footpaths, and public transport, is often designed by those who assume a ‘commuter type’ (that is, white, male, able-bodied, economically stable) and who may exclude the needs of those who do not conform to that type [8]. This can socially marginalise groups of people, such as ethnic minorities, older people, and those with disabilities [8]. Transport infrastructure, if not thoughtfully and inclusively designed, can therefore reinforce social stratification [8]. The concept of ‘transport related social exclusion’ encapsulates people’s inability to participate in the routine, everyday activities of society due to not having transport options [9]. For many New Zealanders, a sense of inclusion in the community and participation is dependent on owning a private car [9].

Transport inequity includes “transport poverty”: [26] a concept that has been defined in numerous ways in the literature but broadly refers to people lacking access to, or being able to afford, transport that is essential to meet their daily living needs for health and wellbeing, and/or the cost of travelling being overly burdensome (a significant proportion of their household budget) [27, 28]. Transport poverty may include a lack of suitable transport options or spending an excessive amount of time travelling (in unsafe or unhealthy conditions) [28]. This leaves people more vulnerable, more socially marginalised, and potentially at risk of poorer health (through greater exposure to traffic accidents, air pollution, etc.) [28]. Transport poverty is more likely to be experienced by Māori than non-Māori, and as a result, Māori may experience greater stress and social exclusion [26]. Other transport injustices for Māori include a higher rate of road traffic and pedestrian serious injuries and fatalities than non-Māori as well as more exposure to air pollution and its associated mortality [10, 20, 23, 26].

Māori and transport

In general, transport is a determinant of health, including mental health: [29] facilitating access to work, healthcare, education, recreational and social supports and many other resources vital to wellbeing [30, 31]. Additionally, for Māori, transport allows access to cultural sites and cultural practices [23], including marae, tūrangawaewae, whānau, kainga and specific geographical components of place that are intrinsic to whakapapa and identity such as mountains, rivers, and the sea [2, 23, 32, 33]. Māori scholars have noted that Māori concepts of ‘home’ extend beyond the house to incorporate ways of moving in and around the environment [12]. Māori access to such cultural sites and practices has been disrupted due to colonisation and many Māori need to travel long distances to reach them, heavily reliant on the private car [23]. These aspects of place play a uniquely important role in ageing for Māori, as for many Indigenous peoples, and are inherent to their identity and wellbeing [22, 34–36]. For example, a recent qualitative study illustrated how connections with place, and holistic views of wellbeing, defined kaumātua transport needs: describing kaumātua who drove to the ocean in order to undertake spiritual practices [32]. However, lack of transport may restrict some Māori from meeting their cultural and whānau (family) obligations [5, 23].

The transport sector needs to rethink its dominant approaches to transport planning to allow Māori (including kaumātua) to address Māori transport needs [5]. In NZ, a strategic move has been underway in this direction, with the 2019 Ministry of Transport’s Māori strategy, ‘Hei Aratiki’ [37], affirming the Ministry’s obligations to Te Tiriti o Waitangi and articulating a vision of “A transport system that enables Māori to flourish”. Transport is fundamental to supporting kaumātua ageing in place. A transport policy response to the needs of kaumātua must also consider the high proportion of the Māori population who live in rural areas. Māori living in rural areas experience greater levels of mortality than their non-Māori peers and this is likely to reflect challenges associated with living rurally [38]. (As noted above, across the general population, Māori also experience disproportionate rates of mortality compared to their non-Māori peers) [39].

Māori and ageing

There is a small but rich body of literature on Māori and ageing (e.g. [2, 4, 23,24,31,32,35,39,40,41,42,43,44]), Concepts that are central to kaumātua transport needs include: a critical emphasis on ageing in place; [36, 40] holistic views of wellbeing; a focus on whānaungatanga, including the importance of intergenerational relationships and collective responsibility; the role of kaumātua as experts within their communities; [2, 32–34, 41–44] and ‘mana motuhake’ (self-determination, independence) [41]. Kaumātua are highly regarded in Māori society and have unique roles with valued knowledge and expertise [2, 41], which is recognised and reciprocated by whānau and community, for example, by the provision of extra support including transport [2]. Additionally, the concept of “ageing well” for Māori may be very different to that of non-Māori [32, 33]. Kaumātua may measure health in terms of active participation in Māori society rather than by the presence or absence of illness; to maintain activity within these traditional roles implies that they require transport [2, 32, 45, 46]. Kaumātua (like many older people) must manage life transitions as they age: [41] these include the loss of independent driving. Successful navigation of these transitions improves health outcomes [41, 44].

Transport and kaumātua

The transport sector may help or hinder the wellbeing of kaumātua Māori; recent studies provide a more focused backdrop of evidence for our study [8, 22, 25]. An overview of kaumātua transport needs is captured in a qualitative study of 39 kaumātua (defined as Māori aged 50 years and over) focused on understanding their wellbeing and supports in the context of Whānau Ora (a government whānau-centred strategy helping whānau to achieve their goals) [25]. In six regions of the North Island, kaumātua viewed transport as a key concern for ageing and those with limited transport options voiced concerns that this exacerbated issues with access, care, loneliness and mental health [25]. In some areas there was a complete absence of public transport, requiring kaumātua to rely on their own resources to get to places. Those unable to drive were less able to access services and those with disabilities reported substantial challenges due to lack of transport options [25].

Other qualitative studies with kaumātua highlight how transport concerns vary according to the urban or rural experience of place [8, 22, 43]. On the East Cape of NZ’s North Island, rural Māori reported often relying on shared mobility to get to places and undertake activities, such as shopping and attending medical appointments [43]. Positively, this shared travel provided opportunities to socialise, share Iwi (tribal) information and converse in te reo Māori (Māori language) [43]. Another study, that included older urban Māori living in Auckland (NZ’s largest city), found that the free off-peak public transport scheme, ‘SuperGold’, facilitated active participation in society, reducing barriers brought about by no longer being able to drive [47]. Two other studies have also explored the many layers of transport disadvantage for Auckland kaumātua [8, 22]. In Mangere, for example, the development of a motorway isolated kaumātua living there and disconnected them from cultural practices, such as gathering harakeke (flax, for weaving) and traditional foods, or visiting moana (the sea) [8, 22]. This community severance highlights the impact of colonised decision-making in the transport sector, and at the time the motorway was developed (1982) the Māori voice was not considered [22]. A lack of transport infrastructure in the area also meant that some kaumātua, who experienced illness or disability, were dependent on others to leave their home, and others faced an unsafe and lengthy journey on foot, alongside a busy motorway, to reach the town centre [8].

A recent study of 12 Māori social housing residents (aged over 41 years) in a large NZ city (Christchurch) explored participants’ experiences of using transport to meet their health and wellbeing needs [12]. Barriers were described, such as problems accessing both public and private transport. These included not being able to afford to maintain a private car, restricting one participant from seeing his children and grandchildren as much as he liked. For another participant, the ‘SuperGold card’ was perceived as an enabler, as he anticipated increased travel (soon) when he reached 65 years. Another participant’s travel needs included trips to his local marae to attend kaumātua groups, which for him was a way of reconnecting with his whakapapa and cultural identity.

The qualitative studies described above shed some light on transport issues for kaumātua. This paper augments the existing qualitative information (synthesised here) and aims to describe the transport practices and plans for driving cessation of a large nation-wide sample of kaumātua Māori, and to understand these practices within the context of a population of NZ older drivers. This description comes from the first wave of the New Zealand Prospective Older Adult Transport and Health Study (NZPATHS). Descriptive quantitative data of kaumātua transport practices is a necessary further step towards understanding the links between transport, health, social inclusion, cultural practices, and ageing in place for kaumātua.

Methods

Study design and participants

NZPATHS is a prospective cohort study that investigates self-regulation and driving cessation patterns, and the impacts of driving reduction and cessation on health and wellbeing outcomes. A stratified random sample of people aged 65 years and older was drawn from the electoral roll. The sampling ensured Māori and people aged 75 years and older were recruited. Inclusion criteria required participants to be active drivers (driven within previous three months) [48] and living independently (community dwelling). This paper reports findings from the 2016-17 baseline interview with 1181 current drivers. The response rate to invitations to participate in the study, after exclusions, was 49%. The methods are fully described in Taylor et al. [49] Project ethical approval was granted by the University of Otago Human Ethics Committee (Health: H15/080) in accordance with National Ethical Standards, as determined by the National Ethics Advisory Committee.

Māori Voice

The overall presentation and interpretation of Māori results in this paper was led by a senior Māori health researcher (SC). Since 2015, the NZPATHS project has been informed by the NZPATHS Advisory Group, which includes a Māori health provider, Turanga Health, Te Tai Rāwhiti Gisborne, and local kaumātua contributed to study design.

Data Collection

Data collection

Data was gathered through computer assisted structured telephone interviews, with socio-demographic, health and wellbeing, and transport and driving practices information collected.

Socio-demographic measures

Characteristics collected: sex (female, male); age (categorised: 65–69, 70–74, 75–79, 80 and older); ethnicity; marital status (married/partnered, widowed, never married/separated/divorced); living arrangements (alone, with partner only, with partner and other(s), with others no partner) and number of people live with (one, two, three or more); highest education (none, secondary, post-secondary); main activity (retired, employed full or part-time); deprivation; and adequacy of financial resources to meet needs (adequate or inadequate) [50–52]. Ethnicity was self-identified using the NZ Census question [53] which allows identification of multiple ethnicities. Participants who identified Māori ethnicity were categorised as Māori; all other participants were categorised as non-Māori [54]. The NZ Indices of Multiple Deprivation (NZ-IMD) [52], a residential address area-level deprivation indicator, was used to classify ‘overall deprivation’ by quintile (least to most deprived); and ‘distance to services’ deprivation (Access Domain) also classified by quintile (least to most deprived). The Geographic Classification for Health (GCH) was used to classify rurality into five categories, two urban and three rural [55].

Health measures

Question one of the 36-Item Short Form Survey Instrument (SF-36) [56] was used to measure general (self-rated) heath (excellent/very good, good, fair/poor). Participants reported diagnosed health conditions from a list of nine conditions (modified from Survey of Family, Income and Employment, [SoFIE]) [57], with the total number of chronic health conditions categorised (none, one condition, two or more) [58]. The EQ-5D mobility question assessed participants’ ability to “walk around” (no problems, slight problems, moderate problems, severe problems, unable to walk around) [59].

Driving and transport measures

Three driving experience questions were asked: Age at first licensure, number of days in a week normally driven, and estimated distance (kilometres) driven in a typical week [60]. To measure driving space [61], participants reported if they had driven to destinations within their neighbourhood, to just beyond their neighbourhood, to neighbouring towns or to more distant towns in other regions in the previous three months.

To ascertain types of transport options used, participants reported modes they had used in the previous three months: options included private car (driving alone, with passengers, as a passenger); walking or cycling for transport; public transport; taxis; volunteer or paid community driving services; and mobility scooter. Participants also reported the types of destinations they had travelled to (by any mode) in the previous three months and how they usually travel there (usual mode), from the following destinations: Post Office, bank or shops (Errands); travel to or from work (Work); doctor, chiropractor, physiotherapist (Health); sports, social, education or volunteer activities (Community); places of worship (Spiritual); visit family and friends (Visits) [62].

Driving dependence and cessation planning

The extent of driving dependence was measured by three questions: (1) Others dependent on participant to drive them; (2) Others available to give participant rides; and (3) If so, how many, with response options 1–2, 3–4 or 5 or more people [60].

Participants reported if they had discussed their driving with family member(s), friends, or their doctor [60], if they had thought about the possibility of stopping driving [51], and if they had made any plans for the possibility of not driving one day [62].

Analysis

Descriptive results from the baseline data were produced using Stata 17, for both Māori and non- Māori (included in tables) [63]. This included basic demographics, self-reported health, driving experience, dependence, cessation planning, trip mode and trip purpose. In all cases, the number of missing responses was negligible, and they were not included in the tables. For measures of driving experience (Table 2), medians are reported because it is likely that these measures in the population are skewed. As an example, most people would get their driver’s licence when they are young with a much smaller number getting their licence when they are older. The median is a more informative statistic than the mean in that situation. Comparisons between categorical variables were made using either Mann Whitney (to compare medians), chi-square or Fisher’s exact tests (for variables with cell counts less than 5).

Table 2.

Driving space, transport dependence and cessation planning of older drivers by ethnicity

	Māori		Non-Māori
	n (173)		n (1008)
Driving experience	median	min, max	median	min, max
Age at Licensure (years)	17	15,53	17	14,66
Number days per week drive	6	0,7	5	0,7
Estimated distance drive per week (km)	80	2, 2000	100	13,500
Driving space and Transport dependence
(Past three months) -Yes %	n	%	n	%
Driven to destinations - immediate neighbourhood	158	91.3	957	94.9
Driven to destinations just beyond neighbourhood	161	93.1	939	93.2
Driven to neighbouring towns	146	84.4	811	80.5
Driven to more distant towns in another region	112	64.7	607	60.2
Yes %
Others depend on them for driving	31	17.9	221	21.9
Rides available from others (family or friends)	160	92.5	965	95.7
Number available to give rides
No-one	9	5.2	38	3.8
1–2 people	56	32.4	399	39.6
3–4 people	57	32.9	391	38.8
5 or more people	47	27.2	174	17.3
Cessation planning
Has discussed their driving with family, friend, doctor (yes)	60	34.7	292	29
Has thought about stopping driving
Not at all	83	48	446	44.3
A little	43	24.9	327	32.4
Some	26	15	165	16.4
A lot	16	9.3	64	6.4
Has made plans for not driving (yes)	7	4.1	110	10.9

Results

This paper presents descriptive baseline data for Māori participants in a prospective cohort study of 1181 current drivers, aged 65 years and over; 15% (n = 173) identified as Māori. A limited number of comparisons between the Māori and non-Māori participants at baseline are also presented (see supplementary tables).

Socio-demographic

Socio-demographic characteristics of participants are presented in Table 1. The Māori cohort had a higher proportion of people aged 65–69 and 75–79 years compared to non-Māori. There were some differences in living arrangements between Māori and non-Māori, for example, a greater proportion of Māori participants were widowed or lived in larger households. Over a third (34.7%) of the Māori cohort (cf. non-Māori, 27.5%) reported that they were still working. A smaller proportion of Māori participants (85.0%) indicated that all/most of their financial needs were met, compared to 93.1% of non-Māori; greater proportions of Māori lived in the most deprived areas. A lower proportion of Māori (39%) lived in the most urban (‘U1’) areas compared with non-Māori (52%).

Table 1.

Socio-demographic and health characteristics of current drivers (CD) by ethnicity (N and unweighted %)

Characteristic	Māori		Non-Māori
	n (173)	%	n (1008)	%
Gender
Female	82	47.4	475	47.1
Age group (years)
65–69	52	30.1	258	25.6
70–74	35	20.2	267	26.5
75–79	52	30.1	264	26.2
80+	34	19.7	219	21.7
Relationship Status
Married/partnered	109	63	690	68.5
Widowed	43	24.9	174	17.3
Never married/separated/divorced	20	11.6	143	14.2
Living Arrangements
Alone	41	23.7	277	27.5
With partner only	95	54.9	643	63.8
With partner and other(s)	16	9.3	55	5.5
With others (no partner)	20	11.6	33	3.3
Number of people live with
One (alone)	41	23.7	277	27.5
Two	110	63.6	672	66.7
Three or more	21	12.1	59	5.9
Highest education level attained
None	61	35.3	255	25.3
Secondary	41	23.7	241	23.9
Post-secondary	71	41	510	50.6
Main Activity
Fulltime employed (30 + hours per week)	29	16.8	107	10.6
Part-time employed (< 30 h per week)	21	12.1	132	13.1
Worker (hours not specified)	10	5.8	38	3.8
Retired	113	65.3	731	72.5
Financial Needs Met
Adequate (all/most)	147	85.0	938	93.1
Inadequate (some/very little)	26	15.0	68	6.7
Deprivation (NZ-IMD)
Least deprived (Quintile 1)	17	9.8	252	25
Quintile 2	33	19.1	223	22.1
Quintile 3	24	13.9	242	24
Quintile 4	40	23.1	178	17.7
Most deprived (Quintile 5)	59	34.1	113	11.2
Distance to Services (NZ-IMD)
Least deprived (Quintile 1)	19	11	124	12.3
Quintile 2	33	19.1	193	19.2
Quintile 3	28	16.2	183	18.2
Quintile 4	44	25.4	261	25.9
Most deprived (Quintile 5)	49	28.3	247	24.5
Urban or rural dwelling (GCH)
U1	67	38.7	521	51.7
U2	52	30.1	217	21.6
R1	30	17.3	170	16.9
R2	18	10.4	87	8.6
R3	6	3.5	12	1.2
Self-rated health
Excellent/very good	107	61.9	667	66.2
Good	48	27.8	273	27.1
Fair/poor	17	9.8	63	6.3
Chronic health conditions (list of 9)
None	63	36.4	408	40.5
One	62	35.8	348	34.5
Two or more	48	27.8	252	25.0
Eq. 5D mobility
No problems with walking around	116	67.1	678	67.5
Slight problems with walking around	35	20.2	203	20.2
Moderate problems with walking around	20	11.6	93	9.3
Severe problems with walking around	2	1.2	27	2.7
Unable to walk around	0	0	3	0.3

Health

Table 1 also provides information on self-rated health and chronic health conditions for Māori and non-Māori. Most Māori participants rated themselves as in excellent or very good health but slightly fewer Māori than non-Māori reported no chronic conditions.

Driving experience, dependence and planning

Table 2 presents Māori and non-Māori driving experiences, driving space, dependence on driving and planning for cessation. Māori and non-Māori participants were very similar in terms of their overall driving behaviours, people depending on them for rides, rides available from others, discussing their driving, and thinking about stopping driving. However, fewer Māori had made plans for stopping driving (p = 0.034).

Transport mode

Table 3 presents information about the types of transport participants had used in the past three months and trip purpose. In the previous three months, nearly all participants had driven with or without passengers and most had travelled as a passenger. These numbers were similar for Māori and non-Māori. Fewer Māori than non-Māori had walked for transport (p = 0.002). Few Māori and non-Māori had cycled or used paid or voluntary driving services. Use of public transport was reported less frequently by Māori than non-Māori (public bus/tram, p = 0.017; trains, p = 0.033). For all trip purpose categories (below), driving oneself was reported as the mode usually used for travel for both Māori and non-Māori (ranging from 77 to 89% across the trip purposes). The next most reported usual modes were travelling with others or walking.

Table 3.

Transport mode use and trip purpose in previous three months

	Māori		Non-Māori
	n	%	n	%
Transport Mode
Driven by self (alone)	172	99.4	1006	99.8
Driven with passengers	156	90.2	921	91.4
Travelled as a passenger	150	86.7	856	84.9
Walking (for transport)	70	40.5	533	52.9
Cycling (for transport)	15	8.7	93	9.2
Public Bus/Tram	31	17.9	266	26.4
Train	17	9.8	162	16.1
Taxi	21	12.1	157	15.6
Volunteer driving service	6	3.5	39	3.9
Paid companion driving service	0	0.0	14	1.4
Mobility scooter	1	0.6	12	1.2
Trip Purpose (any mode)
Errands	168	97.1	1000	99.2
Work	50	28.9	224	22.2
Health	170	98.3	970	96.2
Community	148	85.6	861	85.4
Spiritual	77	44.5	323	32
Visits (family, friends)	170	98.3	988	98

Trip purpose

In the previous three months, nearly all participants had made trips to do errands. Nearly all had visited family and friends or attended health-related appointments and most had made trips for community-related activities. A higher proportion of Māori had made trips to places of worship (p = 0.002) (Table 3).

Discussion

Our data highlight that kaumātua rely heavily on the private car to meet their transport needs, similarly to older non-Māori drivers. Kaumātua need and use the private car to get to a variety of destinations, both near and far, for activities related to daily living. Few kaumātua (4%) had made plans for not driving and this was significantly fewer than non-Māori (11%). However, most kaumātua (93%) had someone they could call on for rides if needed. Indeed, 27% of kaumātua drivers indicated there were at least five people they could call on for a ride if needed. Other transport options including public transport, cycling, and paid or volunteer driving services were used relatively infrequently by both Kaumātua and older non-Māori drivers. After use of the private car, walking was the next most used mode for Māori (41%) and non-Māori (53%). For all trip purposes (including errands, work, health, community/social, spiritual/worship and visiting family/friends), the usual mode of getting to the destination was driving oneself.

A limitation of our study is that we did not collect information about transport to destinations that are specifically associated with cultural practices and activities such as marae and tūrangawaewae. However, we have collected information about a wide variety of purposes for which transport is used, including places of worship for which a substantial proportion of kaumātua reported attending. Our data were collected in 2016 but are the only data available to give us any insight into the situation of Kaumātua driving practices. While subsequent events (including the impact of the COVID-19 pandemic within NZ) may have changed people’s driving behaviours since then, our results are most likely to be indicative of people’s driving behaviour in general (for example, anecdotally, older people still predominantly use the car to get to places). A strength of this study is that Māori are well-represented. Kaumātua made up 15% of the cohort, a proportion which is twice that of the Māori population aged 65 and over residing in NZ [24]. Another key strength is that this study provides quantitative data on kaumātua transport practices. To our knowledge, this has not been done before.

As qualitative research in this area has shown, access to transport can facilitate health whilst conversely, a lack of appropriate transport can result in poorer health outcomes [8, 22, 25]. This is true not only in the westernised view of physical and mental health but also from a more holistic Māori view of health and wellbeing. For example, Meher et al. [22] and Spray et al. [8] demonstrated the limitations of transport planning that excluded Māori perspectives, with consequent health inequities for kaumātua. This evidence underlines the importance of increased transport infrastructure to support healthy ageing.

Our findings provide evidence that the main transport option for kaumātua is the private car, with some reporting walking for transport also. Jones et al. (2025) found similar results with a much younger cohort [24]. Given the ageing of the population and likelihood of driving reduction or cessation for many, better public and community transport options are needed, especially since more Māori than non-Māori live outside major urban areas [38]. Similarly to us, Jones et al. (2025) found lower rates of public transport and walking for Māori compared to their European counterparts; perhaps reflecting accessibility of public transport and characteristics of neighbourhoods, such as the quality of footpaths or safety [24]. In our sample, fewer Māori (39%) were living in the most urban (‘U1’) areas compared to non-Māori (52%), that is, cities likely to have more alternate transport options. Our Māori sample had a higher rate of cycling (8.7%, last three months) compared with Jones et al. (2025) (3.6%/week).⁶³ There may be multiple reasons for this, mostly beyond the scope of our analysis, but including differences in sampling (such as age of the sample, proportion of Māori, reporting periods and the purpose of cycling). Participating in active transport may pose challenges for Māori, who, compared to non-Māori, experience higher rates of long-term conditions at younger ages [64, 65], meaning active transport options may not be equitable. On the other hand, for some kaumātua, active transport has the potential to positively impact on health [10]. In our sample, 87% of both Māori and non-Māori had either no problems or only slight problems walking around, indicative of a reasonably healthy cohort for this age-group.

Our data can be used to inform and support improvements within the transport sector that reduce transport and health disadvantage and inequities and contribute to creating “age-friendly” places [10, 66]. Transport stakeholders must incorporate wider perspectives, including Māori voices, not just those with “the social capital and resources to make themselves heard” (p. 722) [8] to ensure that future transport systems enable Māori access to public transport and equitable active transport. This would facilitate kaumātua social, work, and daily living activities, as well as full participation in Māori society [9]. For ageing in place policies to be practicable, stakeholders and policy-makers must attend to creating truly “age-friendly” cities, towns and rural places that reflect Te Tiriti, ensuring they are “safe and inclusive” [66–68]. A starting point for local governments creating these spaces might be understanding exactly what constitutes “age-friendly” [66]. This could entail engaging with diverse voices, such as those in our cohort.

Participants in this study are part of a larger cohort study of older drivers and their whānau members and have participated in follow-up interviews; the fourth in 2023. This longitudinal focus will allow us to explore changes in driving and transport dependence over time, including becoming a non-driver, and how these relate to health and wellbeing for older adults. Additionally, as an extension to NZPATHS, a qualitative Kaupapa Māori study is underway with kaumātua (drivers and non-drivers) and whānau to better understand their unique experiences and needs in relation to driving, cessation, and transport dependence.

Conclusion

Scholars suggest that Indigenous Māori view ageing differently to non-Māori/non-Indigenous. In older age, Māori transport needs will therefore differ to that of non-Māori. These results provide evidence that kaumātua rely heavily on driving and the private car. When they can no longer drive, this dependence may present barriers to daily living including cultural and other practices that facilitate health and wellbeing. Kaumātua need transport infrastructure in place to support equitable and healthy ageing. This includes public transport and community transport options, especially in more rural regions. Urban environments that support safe walking could enable kaumātua to walk more for transport, although this could be limited by remoteness and health for some. Our descriptive analysis of kaumātua transport practices fulfils a necessary step towards understanding the links between transport, health, social inclusion, cultural practices, and ageing in place for kaumātua. This is highly relevant for health equity in NZ.

Abbreviations

NZ

Aotearoa New Zealand

NZ-IMD

The New Zealand Indices of Multiple Deprivation

NZPATHS

New Zealand Prospective Older Adult and Health Study

SF-36

36-Item Short Form Survey Instrument

SoFIE

The Survey of Family, Income and Employment

Glossary

kāinga

home

kaumātua

older Māori men and women

mana

authority, power

mana motuhake

self-determination, autonomy, control

marae

meeting grounds, belonging to a particular iwi (tribe), hapu (sub-tribe) or whānau (family)

tangihanga (or ‘tangi’)

funeral rites

Te Tiriti O Waitangi

The Treaty of Waitangi, founding document of Aotearoa NZ

tūrangawaewae

‘standing place’, place where one has the right to stand

whakapapa

genealogy, lineage, descent

whānau

family and extended family

Authors’ contributions

SRC reviewed literature, analyzed data, wrote the original draft, led reviews of drafts and editing and contributed to the project administration, conceptualization, and visualization; RMc contributed to the conceptualization, funding acquisition, research design, analysis, investigation, visualization, supervision, writing of original draft, and review and editing; CC contributed to the conceptualization, research design, data curation, analysis, validation, visualization, supervision, writing of original draft, and review and editing; SC contributed to the conceptualization, research design, analysis, visualization, writing of original draft, and review and editing. All authors approved the final manuscript.

Funding

The Health Research Council of New Zealand (HRC15/261:2015–2018) provided funding for this study.

Data availability

The datasets generated and/or analysed during the current study are not publicly available, due to ongoing data collection with this cohort, but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

Ethics approval for this study was obtained from the University of Otago Human Ethics Committee (Health: H15/080) in accordance with National Ethical Standards, as determined by the National Ethics Advisory Committee. All participants gave informed consent to participate in this study.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.