Designing age-friendly streetscapes: Assessing environmental risk factors for falls using street view images

Abstract

As cities worldwide strive to become more age-friendly in response to rapidly aging populations, outdoor falls among older adults remain a persistent challenge that undermines these initiatives. The micro-scale environmental determinants of these falls remain inadequately explored, creating a significant gap in evidence-based urban design for inclusive urban environments. This study investigates the association between built environment features and outdoor fall risks among older adults using data from 6302 emergency dispatch cases in Jeonbuk Province, South Korea. By leveraging deep learning-based computer vision and a zero-inflated Poisson model, we analyze half a million street view images to identify micro-scale streetscape features associated with outdoor fall incidents. Our findings indicate that older adults are more likely to fall in areas with high population density and mixed-use land. While these environmental characteristics show higher fall incident rates, certain streetscape features, such as curbs and brick surfaces, can mitigate fall risks, while asphalt and concrete surfaces may exacerbate them. These findings demonstrate that environments promoting walking require enhanced fall risk management through appropriate design considerations for older adults. By recognizing older adults as ‘mobility minorities’ with specific needs, targeted micro-scale streetscape interventions, such as surface materials and curb designs, can enhance safety while preserving walkability benefits, supporting more inclusive urban environments.