key: cord-289865-36ai2xgy
authors: Paddon, Laura Isobel
title: Therapeutic or detrimental mobilities? Walking groups for older adults
date: 2020-04-28
journal: Health Place
DOI: 10.1016/j.healthplace.2020.102346
sha: 
doc_id: 289865
cord_uid: 36ai2xgy

The health benefits of walking through greenspace have earned widespread academic attention in recent years and have been termed ‘therapeutic mobilities’. As a result, walking groups are actively encouraged by health professionals as a way to promote ‘healthy ageing’. This paper examines whether the promotion of community-led walking groups relies upon overly optimistic understandings that portray walking in greenspace as an inherently therapeutic practice. Accordingly, this paper introduces the concept of ‘detrimental mobilities’ to explore how the shared movement promoted via walking groups may not always be inherently therapeutic and may have some detrimental impacts on the individuals who take part in these activities. Drawing on findings from in-depth walking interviews with older members of the ‘Walking for Health’ scheme in Southampton, England, this paper examines how mobilities have the potential to disable, as much as they enable, health and wellbeing.

The concept of therapeutic mobilities, coined by Gatrell (2013), has grown out of a development of 18 research within health geography into therapeutic landscapes; places that are seen to contribute to 19 improved health and wellbeing. Literature on therapeutic landscapes has enriched understandings of 20 the health impacts of places, with detailed descriptions of the healing benefits of iconic sites, such as the (Laumann et al, 2001) and gardens (Pitt, 2014) . However, the recent 'mobilities turn' has helped develop 23 research that moves from a focus on fixed sites, towards the role of everyday movements through 24 places that can contribute to wellbeing (Doughty, 2013) . This emerging body of research focuses largely 25 on the restorative power of mobility to convey the idea that mobility, as well as place, can contribute to 26 improved health and wellbeing. 

studies have examined the downsides to walking, for instance when it is stressful or burdensome when 33 walking with small children (Bostock, 2001) or in unsafe neighbourhoods (Green, 2009 ). Yet, further 34 research that explores the unfavourable qualities of shared walking is required to examine the 35 downsides of shared walking in different contexts (Hanson et al, 2016) . This paper explores how group 36 walking may negatively influence wellbeing in later life, and contributes to a richer understanding of the 37 relationship between the two. In literature that focuses on places and landscapes, scholars such as 38 Conradson (2005) and Cummins et al (2007) have critiqued the assumption that certain environments 39 create an inherently therapeutic experience and argue for a relational approach to place and wellbeing.

As Conradson (2005, p, 338) states, 'individuals clearly experience even scenic environments in quite 41 different ways, in terms ranging from enjoyment through to ambivalence and even anxiety'. In this 42 study, I argue that presumptions that group walking has intrinsically beneficial influences on wellbeing 43 requires a relational approach that emphasises subjective experience. 44 45 715). Healthy ageing refers to 'optimising opportunities for good health, so that older people can take 48 an active part in society and enjoy an independent and high quality of life' (Healthy Ageing EU, 2018, p, 49 1). Older adults are encouraged to 'age healthily' by taking responsibility for their health through 50 activities that contribute to wellbeing, such as walking groups. However, endorsements of healthy 51 ageing can create a pressure among older people and can be exclusionary to people who cannot, for 52 various reasons, maintain a certain standard of health (Stephens et al, 2015) .

Particularly in older age, group walking in various places has been found to increase fitness, reduce 55 blood pressure and improve mental health (Hanson and Jones, 2015) . Nevertheless, the widespread 56 promotion of walking groups for older people downplays the possible detrimental impacts of shared 57 walking to health and wellbeing and thus portrays a largely romanticised view of group walking. Walking 58 groups are often prescribed as a way to improve health, without considering the individual issues of 59 older adults, and shared walking in older age is rarely spatially nor relationally understood. For instance, 60 health professionals may not appreciate where people walk and the impacts of this on a person's 61 wellbeing, as well as who they walk with or encounter and how this impacts on their wellbeing.

In the current climate of austerity in the UK 1 , walking groups are increasingly promoted by health 67 professionals because they are usually free for members to join and are volunteer-led, so do not incur 68 costs to the government or local authorities. The austerity measures of the UK government, as well as 69 the previous 'Big Society' agenda, has seen responsibility for health and wellbeing shift from local 70 authorities to communities and individuals (Lowndes and Pratchett, 2012). Cuts to government funding 71 have resulted in the closure or reduction of many public services for older people, such as day centres, 72 meals-on-wheels and home-care support (Age UK, 2015) , therefore older adults are being encouraged 73 to take a greater responsibility for their health and wellbeing to ensure they are leading active and 74 healthy lives (Kuh et al, 2014) . This promotion and increase of self-responsibility for older people may 75 mean that the detrimental qualities of physical activities are overlooked. Furthermore, there is a need to 76 examine whether older individuals are reaping the benefits that they are assumed to gain from walking 77 groups.

In this paper I am not seeking to challenge the idea that shared walking has many health benefits.

Rather, I question the assumption that shared movement is inherently therapeutic or indeed inherently 81 disabling. Through an in-depth ethnographic study of a walking group, I explore how the same form of 82 mobility can be both beneficial and damaging in different ways to different people. I aim to encourage a 83 shift from romanticised accounts of shared walking to consider both the positive and negative influences 84 of shared walking on health and wellbeing.

In doing so, I introduce the concept of 'detrimental mobilities' and argue that this concept needs to be 87 considered when exploring the wellbeing implications of shared walking. The concept of detrimental 88 mobilities conveys the idea that shared mobility and movement are not imbued with intrinsic beneficial 89 properties but can actually result in unintended, unfavourable impacts to wellbeing for some people. were to take part. The groups consisted mainly of white older women, thus the study's participants 149 reflected the overall group membership. I then joined each walking group on their walk, and it was 150 during these walks that ten of the members expressed their willingness to be part of the study. All ten 151 interviews were walking interviews and participants chose to either undertake the walking interview at 152 the same time as one of the walking groups -but walking further behind the group -or on a different 153 day altogether. Five of the participants decided to arrange their walking interview for the same time and 154 route as the walking group, thus I was also involved in participating in the walking groups, which allowed 155 for a deeper ethnographic understanding of how these groups function. Each interview lasted 156 approximately thirty to fifty minutes and was audio-recorded. Participants were asked questions about 157 how and why they came to join the walking group, the benefits they gain from the walking group and 158 any issues they have with the walking group. Before the data collection period, ethical approval was 159 gained from the University of Southampton's Ethics committee.

Small-scale, purposively selected samples are generally used for exploratory qualitative research 162 because it favours depth of illustration over representation (Ritchie et al, 2013) . I had approached both 163 walking groups and ten members agreed to take part in the study. I analysed the data throughout the 164 data collection period, and data saturation, defined as the 'point at which no new themes or codes 165 emerge from the data' (Clarke and Braun, 2020, p, 1) was reached by the tenth interview. Robinson

(2014) argues that this commonality of experiences between the participants could be because of the 167 lack of heterogeneity within the study sample and therefore the walking groups as a whole, because the 168 participants' characteristics reflected the overall makeup of the walking groups. Although the sample size is small, the depth of the narrative data I uncovered satisfied my study's aims and as a lone 2.4 Walking Interviews

The study of walking and use of walking interviews is a burgeoning field within social sciences (Carpiano, to respond accurately about their experiences. In this study, participants were interviewed individually 188 and the route of the walking interviews were chosen beforehand by each participant, so that they could decide how far and over which terrain they would prefer to walk. This paper argues that the wellbeing implications of walking groups are often over-romanticised, with 192 shared walking presumed to be fundamentally therapeutic. Likewise, I do not wish to romanticise the 193 walking interview as a way to somehow gather more 'accurate' research data. Accordingly, the benefits 194 of walking interviews should not be over-emphasised or thought to be without problems, an assumption 

Firstly, I transcribed the data verbatim and familiarised myself with the data through re-reading. After, I 234 created initial codes from the data using nVivo version 12 software. These were codes that were 235 interesting and meaningful to my research aims (Braun and Clarke, 2006) . The codes were then collated 236 into potential themes which I reviewed, and I produced a thematic map which best represented the data and was supported by codes and the relationships between them (Clarke and Braun, 2014) . At this 238 stage, some themes, such as 'importance of nature' and 'healthy ageing' remained closely related to the 239 therapeutic landscapes and therapeutic mobilities literatures. However, my thematic map also included 240 many interpretive themes, such as 'lack of integration' and 'personal comparisons' that had been 241 inductively generated. Thus, the focus on detrimental mobilities emerged more inductively during the 242 data collection, analysis and as the study unfolded. I decided to focus this paper on the themes which 243 showed the detrimental aspects of the walking groups because these were more interesting, meaningful group'. These participants find that despite the shifts in who is walking (or sitting) with whom, the same 294 members generally stick together in a clique that is exclusionary to others.

Nevertheless, not all participants had issues with the cliques of the walking groups. Wendy, aged 71, has 297 been attending both walking groups for six years. Wendy joined the waking groups with a friend who 298 shares her passion for walking and being out in nature. As well as being a member of WfH, Wendy takes 299 part in Ramblers walks and feels such walking groups provide her with both exercise and friends. Unlike 300 some of the other participants, Wendy has no issue with the cliques of the walking group, one of which 301 she is included in: 302 303 "We tend to have our little groups. So, there's a group that I am part of if you like and we do tend to integration between some group members. During the interview, she described some spin-off activities, 309 such as trips to cafés and to the cinema, which were generated from the walking group. However, it was 310 clear that these trips were only welcome to certain people, possibly those who were part of her clique. 

That is not to say that shared walking cannot produce therapeutic landscapes that can have healing 322 benefits for those involved. Doris, aged 80, describes how the conversations she has with other walkers 323 helps to reduce the stress she feels in her daily life and other participants spoke of the intimate 324 conversations they have had with other walkers, such as when Ada's mother passed away. Nevertheless, interaction, suggests that social wellbeing is not necessarily gained by being part of a walking group and 327 thus shared mobility is not inherently therapeutic.

The social aspect of these groups can create anxiety and exclusion for some, and while other research 330 into walking groups has explained this anxiety as something newer members feel about joining group 331 activities (Hanson et al, 2016) , here, some participants who have been attending for some time are still 332 feeling excluded from the group. Moreover, while sociality is important in the creating of therapeutic 333 mobilities (Doughty, 2013), lack of sociality is also important in creating detrimental mobilities. Likewise, 334 just as engaging in supportive social environments is beneficial for combatting social isolation, engaging 335 in unsupportive social environments, and feeling excluded or rejected, is damaging for social wellbeing.

Furthermore, it is important to note that this research did not include the voices of those who perhaps 337 feel so excluded that they no longer attend the walking groups or feel so excluded that they have not terrains of Southampton Common, such as the rough grassland or the woodland, she would often head 393 straight to the café to wait for the other walkers to finish the walk, rather than walking with them.

actually hinder the benefits gained by group members who cannot cope with these changes as much as 396 the other members.

These narratives thus suggest, perhaps unsurprisingly, that walking groups can be exclusive to people 399 whose physical ability falls below a certain level. During the walks, walk leaders stop at regular intervals 400 to ensure that members at the back of the group can catch up with those at the front, which allows a 401 few moment's rest for many walkers. Yet, for those at the back of the group, who perhaps, like Eileen, 402 cannot walk as fast, these built-in halts do not provide any rest and could in fact pressure some 403 members into walking faster in order to catch up. Eileen's story highlights an issue of universally 404 prescribing walking groups with the view that they are inherently restorative and relaxing in the same 405 ways for all (Carpenter, 2013) . The pressure that members feel to maintain the pace of the group could 406 also have relevance to other group activities, such as cycling groups, long-distance swimmers or park-407 runners, where the therapeutic experience depends on one keeping pace with a group. Therefore, 408 assuming that shared mobility is valuable to people in the same ways overlooks the nuances between 409 mobility and wellbeing, and the diverse ways in which shared walking is experienced by individuals.

What these participant's narratives also show is that detrimental and therapeutic mobilities may not 412 instantly impact on one's wellbeing or always have the same impact. For instance, Eileen was no slower 413 or less able to walk on uneven surfaces than other members when she joined the group eight years ago, 

Healthy ageing discourse, as well as funding cuts to social and physical activity services for older people, 430 mean that walking groups are increasingly promoted by health professionals as a means of improving 431 the wellbeing of older adults. This paper has introduced the concept of detrimental mobilities to 432 highlight that shared mobility is not always inherently beneficial for all individuals, thus promoters of 433 walking groups should avoid romanticising their benefits. Taken together, the findings from this study 434 complicate the boundaries between positive and negative therapeutic experiences and the assumption 435 that membership in a walking group is entirely advantageous. These participants are members of the 436 same walking group, therefore health professionals may presume that they each experience the walking 437 group in a similar way and that they all draw the same healing benefits from each walk (Carpenter, 438 2013). Their experiences emphasise the importance of examining mobilities at an individual level, and 439 with a relational approach that recognises the interplay of people and place. The findings promote need for a shift in thinking from walking groups as homogenously beneficial for all members, to also 443 understand the unintended, detrimental impacts of shared walking in older age.

This paper has the potential to enrich the understanding of wellbeing as an intersubjective and 446 fluctuating experience, which will open up ideas surrounding how wellbeing is influenced by shared 447 movement. This study also has implications for research into therapeutic mobilities and contributes to a 448 richer understanding of the relationship between mobility, old age, and health and wellbeing. The focus 449 of this paper has only been on shared walking as a form of mobility and the findings are based on a small 450 self-selected sample, thus they cannot represent the experiences of all older adults in walking groups.

This paper does not seek to disregard the notion that shared walking through greenspace is therapeutic 452 or beneficial to health, but instead seeks to emphasise that shared mobility also has the potential to be 

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We estimate that

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Highlights: • 'Detrimental mobilities' refers to negative impacts of shared mobility on wellbeing • Walking groups can result in unfavourable impacts to the wellbeing of individuals • Shared movement can be exclusionary in terms of sociality and physical ability • There is a need to question romanticised accounts of shared walking in older age

Acknowledgements: Many thanks to all the participants of this study. Thank you to Dr Eleanor Wilkinson for her advice and support, to Dr Andrew Power and Dr Ros Edwards for their comments and my sister Zoe Elmore for help with proof-reading.

The transient nature of the walking groups helps participants to open up and permits an ease in the