How does driving license withdrawal affect subjective well-being? A Swedish comparative survey study of visual field loss

Nyberg, Jonna; Björklund, Gunilla; Aretun, Åsa; Berg, Hans-Yngve; Strandberg, Thomas · 2021 · Crossref

DOI: 10.1186/s12544-021-00511-4

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Summary

This study investigates the impact of driving license withdrawal due to visual field loss (VFL) on subjective well-being (SWB) in a Swedish context. Motivated by the high prevalence of car dependence and the increasing number of medical license withdrawals, particularly among aging populations, the research addresses the gap in understanding how transport accessibility influences SWB for individuals with impairments. The authors posit that access to transport facilitates participation in activities that generate well-being, and thus, license cessation may negatively affect SWB. The researchers conducted a comparative web survey involving 436 participants recruited through patient associations and the Swedish National Road and Transport Research Institute. Participants were divided into three groups: those with a driving license and no VFL (n=80), those with a license and VFL (n=91), and those whose license was withdrawn due to VFL (n=265). All participants had a diagnosis capable of causing VFL. SWB was measured using standardized items assessing life satisfaction and affects. Accessibility was evaluated through the frequency of trips to various activities, use of transport means, and perceived access to transport. Statistical analyses, including multiple linear regression and non-parametric tests, were employed to compare groups while controlling for demographic variables such as age, gender, and employment. The results demonstrated a significant negative effect of driving license withdrawal on SWB. The no-license group reported lower overall life satisfaction and fewer positive affects compared to both license-holding groups. Specifically, the mean life satisfaction score for the no-license group was 4.69, significantly lower than the 7.05 for the license group and 8.33 for the license-VFL group. The no-license group also perceived significantly less access to transport means necessary to live a satisfied life. While this group relied heavily on getting lifts in cars, they expressed a strong desire to drive. Regarding activity participation, the no-license group made fewer trips to work, studies, and leisure activities than the other groups. Interestingly, the license-VFL group often reported higher trip frequencies for leisure and social visits than the license-only group, suggesting that VFL alone does not necessarily reduce mobility if driving is permitted. The study concludes that driving license withdrawal due to VFL significantly reduces subjective well-being, primarily by limiting perceived transport accessibility and actual participation in daily activities. The findings highlight that qualitative aspects of transport access, beyond mere trip frequency, are crucial for well-being. The authors emphasize the need for further research into these qualitative dimensions and suggest that the current car-dependent infrastructure exacerbates the negative impacts of license cessation, particularly for those who cannot easily substitute car travel with other modes.

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• sleep deprivation