The concept of urban mobility: articulating actions in occupational therapy

Abstract

Urban mobility is a concept that has been employed in various publications and is used by different areas of knowledge. Urban mobility is indispensable for the consolidation of the right to the city, being a fundamental dimension for the everyday lives understanding of the individuals and groups. This article discusses the possibility of incorporating the concept of everyday urban mobility in occupational therapy. For this purpose, it is presented the concept of urban mobility by different areas of knowledge, such as urban planning, engineering, geography, and social sciences. Based on the construction of an expanded understanding of this concept, we sought to reflect on how the articulation between the concept of urban mobility and practices or fundamentals of the profession has been doing. With support in the literature of the area, four possibilities of articulation between urban mobility and occupational therapy were categorized: urban mobility as (1) a component of the occupational therapy evaluation, (2) an occupational therapeutic resource/tool, (3) the objective of the intervention and (4) the action in urban planning public policies. Considering the dimensions related to urban mobility, such as the social, physical, and attitudinal factors related to its effectiveness, integrated in a relevant way to the everyday life of the people; it is understood that this concept can be incorporated by occupational therapists in their professional practices and their studies for the realization of a critical action that aims the social participation of the individuals with whom the professional work with.

Keywords:
Occupational Therapy; Right to Freedom of Movement; Cities; Urbanization; City Planning

Resumo

Mobilidade urbana é um conceito que tem sido empregado em diversas publicações e é utilizado por diferentes áreas do conhecimento. A mobilidade urbana é indispensável para a efetivação do direito à cidade, sendo uma dimensão fundamental para a compreensão do cotidiano dos sujeitos, individuais e coletivos. Este artigo discute a possibilidade de incorporação do conceito de mobilidade urbana na terapia ocupacional. Para tal, apresenta o conceito de mobilidade urbana por diferentes áreas do conhecimento, como o urbanismo, engenharia, geografia e ciências sociais. A partir da construção de seu entendimento ampliado, busca-se refletir sobre como se dá a articulação do conceito com as práticas ou os fundamentos da profissão. Com apoio da literatura da área, categorizou-se quatro possibilidades de articulação entre mobilidade urbana e terapia ocupacional, sendo elas: a mobilidade urbana como: (1) um componente da avaliação da ação do terapeuta ocupacional, (2) um recurso terapêutico-ocupacional, (3) o objetivo da intervenção e (4) no trabalho com políticas públicas de planejamento urbano. Considerando as dimensões relacionadas com a mobilidade urbana, como os fatores sociais, físicos e atitudinais relacionados à sua efetivação, integradas de forma relevante ao cotidiano de vida dos sujeitos, entende-se que este conceito pode ser incorporado por terapeutas ocupacionais em suas práticas profissionais e em seus estudos para a efetivação de uma ação crítica, em busca da participação social dos sujeitos com os quais o profissional trabalha.

Palavras-chave:
Terapia Ocupacional; Liberdade de Circulação; Cidade; Urbanização; Planejamento de cidades

Introduction

Urban mobility is a concept that has been used in several areas of knowledge, being disseminated in multiple publications. Several definitions can be found but we need to highlight that, even within the same field of study, it is not something consensual, characterized as a polysemic and interdisciplinary term (Florentino, 2011).

We can say that the discussion on urban mobility is directly related to the concept of “right to the city”, introduced by Henri Léfèbvre, in 1969. For the author, the right to the city is related to the right to participation and the appropriation of the city, the right to “places of meetings and exchanges, to the rhythms of life and use of the time that allow the complete use of those moments and places” (Léfèbvre, 2001, p. 139). For him, the right to the city is “a superior form of law” (Léfèbvre, 2001, p.134), and, for some organized social movements that fight for this agenda, it is characterized as an essential human right, as proposed by the World Charter for the right to the city.

Not addressing the discussions about the different dimensions of law here, we point out the presence of the theme on the agenda of various social movements. In Brazil, the beginning of this demanding agenda can be traced back to the 1980s, starting with the National Movement for Urban Reform (MNRU, Movimento Nacional de Reforma Urbana). The collective organization of that movement managed to include in the Federal Constitution of 1988 two chapters on Urban Policy (chapters 182 and 183), which culminated later in the institution of the Statute of Cities (Brasil, 2011) and the creation of the Ministry of Cities (in 2003). Such legislative instruments include, in urban management, the participation of several actors interested in this discussion, possible by the National Conferences of Cities and the National Council of Cities (Cafrune, 2016; São Paulo, 2015).

In this perspective, the concretization of the right to the city is linked to urban mobility, because “[...] mobility is a crucial dimension of the right to the city, allowing integration between people and spaces [...]” (Florentino, 2011, p. 47). Traditionally, studies on urban mobility have focused on the field of engineering and urbanism (Florentino, 2011), with a focus on issues related to traffic and transportation. However, it is considered a restriction to the physical displacement of the individuals, insofar as moving and/or circulating political, cultural, social, and subjective elements, and the physical aspects.

Considering this debate, in this work, we focus on the concept of mobility based on the inclusion of different dimensions of everyday life. Thus, when using the term urban mobility, we refer to a notion that surpasses the idea of physical displacement and also analyzes its causes and consequences, that is, it seeks to address the social transformations related to movement, the meanings of these displacements for the life of people and groups, understanding mobility as a social practice (Balbim, 2016; Souza, 2014) marked by the social place occupied by individual and collectives in their lives. In this sense, we understand that the expression urban mobility incorporates, in an implicit way, the everyday adjective, because it is the place where mobility occurs. Thus, we understand that urban mobility refers to the concrete daily lives of individuals, groups, and communities.

Therefore, the concept of urban mobility applied in this text refers to a social practice, defined by the meanings, impacts, and representations of the daily movements of people and collectives through the urban space, being essential for their social participation and effective citizenship. Therefore, urban mobility occurs in everyday life, marked, influenced, and sometimes determined by the social position of the individuals and their possibilities in social life. From this relationship, we can think of it as an important element to be considered in practice in occupational therapy, as we work with daily life as the occupational therapist locus of action (Galheigo, 2003; Malfitano, 2016). Therefore, through this article, we aim to reflect on the contribution possibilities of the concept of urban mobility incorporation to the occupational therapy practices.

Urban Mobility and occupational therapy: what are the possible relationships?

All professions have their epistemological underpinnings and theoretical foundations modified “[...] as values and configurations of political powers change in the contexts in which they are inserted [...]” (Medeiros, 2000, p. 62). In a capitalist society marked by different socioeconomic inequalities, fighting for the confrontation of such inequalities and seeking freedom, participation, emancipation and the guarantee of human and social rights of different individuals and groups become the foundations of occupational therapy practice for professionals who critically analyze the profession given the context in which they operate (Córdoba, 2012; Algado, 2016).

In the 1970s, for example, during the period of the civil-military dictatorship, a reflection began on the models and practices of occupational therapy in force until then in Brazil, when professionals began to rethink their actions within the institutions and to seek new foundations to build innovations in the ways of acting. These reflections led to the composition of “[...] an innovative practice in occupational therapy marked by the territorial principle of assistance [...]” (Barros et al., 2007, p. 355), which sought to approach the individuals and reach the real spaces of life, with its objectives, techniques, and fundamentals. In this way, the discussion about territory, among others, became part of the body of concepts for the education and the occupational therapist practices.

In the discussion about the conceptual theoretical references of the profession, several concepts have been incorporated by occupational therapists about their identity and professional practice, such as occupation, activity, everyday life, ways of life, social inclusion, social participation, among others. Considering the relevance of this debate, in this text, we explain the approach to the everyday life concept, which has been used by occupational therapists since the 1990s (Galheigo, 2003). Initially, it was more used by the social sciences, based on the understanding that to apprehend social processes of individuals and collectives, only a look “from within”, that is, the detailed dimension of life, can provide an understanding of the experiences and their meanings and their representations. In occupational therapy, its incorporation comes from a critical reading of the practices, at a time when occupational therapists increasingly sought to contextualize them with reality, encompassing the social, historical, economic, and cultural context, and the forms of collective inclusion and participation of the individuals and groups (Galheigo, 2003).

In this perspective, territory and everyday life are integrated, as they move towards the context in which people live. We add that territorial work in people's everyday lives requires, among other issues, addressing mobility, access, and restrictions to the different geographical spaces that make up the lives of individuals, groups, and/or communities. Whereas occupational therapy works with populations in various situations of vulnerability, whose rights are violated and their social participation is limited due to different factors and in different contexts, and which aims to seek some level of social transformation (Galheigo, 2012), incorporating reflections on the mobility of individual and collective composes the construction of critical thinking about the profession epistemology and practice.

We argue that the study of urban mobility by occupational therapists may be relevant to their practices and research. To defend such an argument, we will present below the discussion of urban mobility as an assessment in occupational therapy, a resource of practice to achieve the proposed objective, the final objective of the intervention, or even to justify the inclusion of the professional in the discussion of public policies for urban planning. Although we propose an analytical division of these four possibilities, the boundaries between them are often articulated, and do not delimit individualities, but shared and common characteristics, especially when we speak of evaluation, resources and objectives.

Urban mobility as an assessment tool

Assessments and assessment protocols in occupational therapy are highly valued in practices and research by professionals in the area (Cavalcanti & Galvão, 2007).

Applying the discussion of assessment in occupational therapy and the urban mobility, we need to consider several factors that influence mobility, and they can be divided between personal factors, always considering individual and collectives aspects (gender, age, education, physical conditions, income, ethnicity, religion, and culture); family (life cycle, possession of a private vehicle) and external (offer of means of transport, location of the desired destination, opening hours of destinations and means of transport, personal security).

From the perspective of the right to the city, as proposed by Léfèbvre, evaluating it is important for occupational therapists who work in most sub-areas of the profession, as it is an informative element about the everyday life of the person, group, or community, where the person is or will return. This assessment can predict, for example, how the access to different services and public spaces is; to point out the possibility of inclusion and maintenance in the job market; unveiling the use of time in everyday activities; to point out individual and collective needs and desires to be in places; understand how are the physical, cognitive and psychosocial functions that are necessary for good mobility in cities; use as an appraiser of the implementation of public accessibility policies; assess the need for the use of assistive technology equipment to aid circulation; among other possibilities.

Some publications already define the concept of mobility and propose its evaluation and measurement. For the AOTA - American Occupational Therapy Association (2015) ¹ for example, mobility is “planning and moving in the community and using public or private transport, such as driving, walking, cycling or accessing and moving by bus, taxi or other transportation systems” (Cavalcanti et al., 2015, p.20).

In the instruments most commonly used by professionals, the term mobility appears more frequently referring to the transfer of positioning, as in the Functional Independence Measure – FIM (Riberto et al., 2001), and in the Pediatric Evaluation of Disability Inventory – PEDI (Mancini, 2010). On PEDI, the item mobility also assesses locomotion and the external environment, for example. The FIM uses the term locomotion to assess march, the use of a wheelchair and the ability to climb stairs. The Health Assessment Questionnaire – HAQ (Stanford University School of Medicine, 2018) has questions about walking in flat places, going up and down stairs, and about the use of public transportation (Mello & Mancini, 2007).

We emphasize that, although the mobility approach is important in the evaluations already used by occupational therapists, we still need to consider other aspects that. We propose a reflection that is not included in instruments that use numerical scales with a measurable perspective of predetermined items. If we are proposing the concept of urban mobility as a social practice, which refers not only to movements in space, but also to the social meanings, and effects that are caused by these displacements, we need to think that the concept of urban mobility can be incorporated in other ways in the assessment that make up the occupational therapist work. The article by Borba et al. (2017), for example, presents an experience in this direction. To get closer to the everyday lives of people who attended a social service, professionals sought to know where they were in the city, circulating with the person, going to the spaces they frequently go, and trying to understand how their inclusion and participation in the urban life took place.

Therefore, that qualitative assessment and those that consider subjective aspects are possibilities for approaching urban mobility, and occupational therapists have already used this assessments perspective (Cavalcanti & Galvão, 2007; Rocha & Brunello, 2007). For that, several resources can integrate them, such as open interviews, life stories, use of maps, cartography, ethnography, activity groups, field diaries, among others.

Hence, we can infer that the inclusion of aspects related to the concept of urban mobility as an assessment or part of the evaluations in occupational therapy is already carried out, notably when referring to the discussion on physical accessibility (Cavalcanti et al., 2007, 2013). However, the expansion of this concept would contribute to a more qualified assessment of the concrete everyday lives of people. Such an approach adds the subjective and social aspects and contributes to the planning of interventions that extend to the territory and the mobility of the person through it, providing more possibilities for social participation.

Urban mobility as a resource for practice

We consider occupational therapeutic resources the means/instruments that the professional uses in the development of his/her practice to achieve his/her goals. These resources are diverse and include activities, techniques, and methods. Although usually urban mobility does not appear as a concept in articles, interventions carried out reveal that practices do use mobility, in the sense that we propose in this reflection, as a resource for their actions.

We understand that urban mobility is essential for the recognition of the territory and its subsequent appropriation, enabling future social participation, the concretization of the right to the city, and building and consolidating territorial social networks. Occupational therapy practices, especially social occupational therapy, to appropriate the territory and strengthen social networks in the search for social participation, have been frequent since the 1970s, when discussions in this field began. Currently, based on a critical perspective of the profession, which seeks to address contemporary social problems, which is present in all areas of the occupational therapist, such issues have also appeared in publications in the mental health area, in physical rehabilitation, in community and cultural health practices, for example. We can mention, among others, the publications of Almeida & Oliver (2001), Castro et al. (2016), Castro & Maxta (2010), Oliver et al. (2000).

One of the examples of professional actions resources used by occupational therapists is the articulation of social networks and services, and the promotion and access of individuals and collectives to the services and spaces that they are entitled to. The articles by Ferigato et al. (2016), Kemper et al. (2015), and Lopes et al. (2011) are some examples. Circulation through the city can be a resource for the articulation of territorial social networks, as we can see in the excerpt:

Also, it invested in its unique territorial accompaniment, seeking to get to know the city from her perspective. As she had the experience of living on the streets for many years, her resourcefulness when walking through the center of the city was evident. It was also during these walks that she identified, little by little, many people and known places, at the same time that she was recognized by several people, both passers-by and formal and informal traders in the region (Borba et al., 2017, p. 209, our emphasis).

Another example comes from an article in which the action taken by occupational therapists was characterized by promoting access to different public spaces in the city by socially vulnerable children. The argument is that, through the circulation in different spaces, it was sought to carry out activities of coexistence with the difference, with the appropriation and with the awareness of rights to public spaces and access to leisure activities (Soares et al., 2009).

Due to the experiences reported by Soares et al., we can infer that although it is not yet incorporated as a concept by occupational therapists, urban mobility can and has already been used as one of the occupational-therapeutic resources through “going together” to spaces, from the development of individual and collective activities by the city, together with an existing group or the incorporation of new collectives. It includes information on the possibilities of places to go, the ways of access, the routes, and the necessary and/or chosen/desired detachments. However, we understand that the incorporation and study of urban mobility as a concept can subsidize these practices more theoretically, supporting them.

Urban mobility as an intervention objective

Urban mobility can also be the goal of intervention in occupational therapy since it is understood more than just coming and going, but also the possibility of producing new forms of collective social life, in addition to having subjective meanings, that is, it is related to the search for greater social participation of the individuals, groups and/or collectives.

In the context of Anglophone publications on occupational therapy, the concept of mobility seems to be more focused on the issue of circulation in the physical space, and its circulation creation and/or expansion may be the objective of the occupational-therapeutic action. Di Stefano et al. (2009, p. 5) define what they call community mobility as the “[...] peoples’ ability to transport themselves around their local area and includes activities such as walking, cycling, driving, or using public transportation or other mobility devices such as powered wheelchairs or scooters”. In this perspective, the word mobility focuses on accessibility to public spaces and public transportation for people with disabilities or reduced mobility (Cassapian & Rechia, 2014; Cavalcanti et al., 2013; Di Stefano et al., 2009; Logan et al., 2004; Sackley et al., 2009; Vieira et al., 2015; Volpini et al., 2013).

From the perspective of psychosocial care, Soares et al. (2009, p. 197) report interventions carried out in different contexts whose objective is “[...] to favor production and collective exercise, promoting the strategies of circulation and city exploration, as well as the exchanges that unfold, promoting greater accessibility and social relevance”. To this end, strategies were used, such as mapping territories, strengthening social networks, and using different public spaces to carry out professional actions, which took place with different populations. We can affirm that Soares et al. presented urban mobility as an objective of their intervention since in addition to carrying out trips around the city and reflecting on the necessary implications for them, they sought to develop activities that worked with the appropriation of themselves and their surroundings, considering sensations, affections, difficulties and interests involved in the process of everyday mobility.

Depending on each context and the result of the work, it can also stop being objective and become a resource for intervention. The publication by Baldani & Castro (2007) is an example that demonstrates the overlap between assessment, resources, and objectives in the practice of occupational therapy. In this article, they present the experience of acting with a child who lived in a situation of social vulnerability. These focus on mobility processes as an element/resource to achieve the objective of the intervention: “[...] we assessed that exploring the territory with it would provide a new experience for M. to inhabit the world [...]. In this sense, it is necessary in the first place the world be presented by someone” (Baldani & Castro, 2007, p. 4).

We realize that urban mobility is an objective found in part of the occupational therapy literature, whether focusing on people with disabilities, children, adults, or the older people; health patients, education, and social assistance services; or individuals in social vulnerability. Depending on each context and the result of the work, it can also stop being objective and become a resource for intervention.

Occupational therapy in public urban mobility policies

Another possibility of inserting the concept of urban mobility in occupational therapy practices refers to the participation of these professionals in public policies for urban planning, which consider mobility as an essential aspect of everyday life in cities. It is the emphasis on the articulation between public policies and occupational therapy, emphasizing the individual's everyday life and needs to facilitate citizens' access to life in the cities (Correia et al., 2018; Correia et al., 2018; Di Stefano et al., 2012; Jónasdóttir et al., 2018; Jónasdóttir & Polgar, 2018; Parnell & Wilding, 2010).

We found reflections on occupational therapy in urban planning actions in some publications that bring positions about this possibility of action. Jónasdóttir & Polgar (2018) affirm that occupational therapists have explored the issue of mobility in its physical sense, but have not focused on the policies related to them. With these same researchers, a 2018 study raises the possibilities of occupational therapy practice related to mobility. As they use the theoretical reference of Occupational Science, they defend the need to incorporate the concepts of this area, specifically occupational rights and occupational justice² for the implementation of mobility policies, and to list the occupations and the resources necessary for them to be carried out in the formulation of public policies (Jónasdóttir et al., 2018). Another publication points out that one of the roles of the occupational therapist is the participation in politics and the development of research on urban mobility, placing the theme as an agenda for the profession (Di Stefano et al., 2012).

In Brazil, the discussion of occupational therapy in urban planning is recent. Correia et al. (2018, p. 356) identified occupational therapy actions in three categories in urban planning: collective occupations, community approach, and community readings, arguing that professionals can “collaborate as consultants”, given their knowledge of participation.

The article by Correia et al. (2018) presents the strategies carried out by occupational therapists to effect collective participation in urban planning policies, for example, the participatory social development of the City Statute, which is: immersion in the knowledge of the local reality, mapping of social support networks, conversation circles and activities workshop. These resources, which are widely incorporated into occupational therapeutic practices in general, sought to make the population aware of their needs and their possibilities of collective political participation in claiming local demands for their development (Correia et al., 2018).

When thinking about the inclusion of the profession in the urban policies debate, in addition to the already essential necessary knowledge shown by Correia et al., we add the need for a conceptual appropriation of the constituent elements of such policies, such as the concept of urban mobility. Such a concept, with its focus on the concrete everyday lives of people, would enable to approach urban planning actions that envision the accessibility, physical and subjective, of the largest possible number of people in the city’s context.

Final Considerations

Considering the discussion in the human and social sciences, and the occupational therapy literature on the uses and applications of the mobility concept, we present everyday urban mobility as the physical displacements performed daily by people and groups in the urban space, implied by meanings related to the socio-cultural context, transformed and transforming social relationships in cities. We argue that the study of urban mobility by occupational therapists can be relevant to their practices and research, and can be used both as an assessment in occupational therapy, a resource of practice to achieve the proposed objective, the final objective of the intervention, or to justify the inclusion of occupational therapists in the public urban planning policies.

Using the concept of urban mobility in evaluations in occupational therapy can help professionals to better understand the dynamics of individuals and groups everyday lives, analyzing the objective and subjective, historical, social, and cultural dimensions of their circulation, and aspects that could be included in occupational therapeutic projects. Used as a resource, if an individual or group has difficulties in be inserted in the spaces they want in their daily lives, mobility can be used in occupational therapeutic follow-ups. As a practice objective, it integrates strategies to seek a higher level of social participation.

Considering the expansion of the concept of everyday urban mobility, which encompasses new perspectives, especially of its social aspects, we understand that this concept can be incorporated by occupational therapists to support their practices and studies. If occupational therapy, as a profession, seeks to play a critical position that effectively considers people's everyday lives, it is necessary to focus on the different dimensions and contradictions that compose it. Urban mobility is one of them and extremely relevant, as it demonstrates social, physical, attitudinal factors that prevent and/or limit the real exercise of social participation.

Acknowledgements

This work was carried out with support from the Coordination of Superior Level Staff Improvement (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES), Brazil, financing code 001.

• 1
  American Occupational Therapy Association (2015). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupatinal Therapy, 68 (Suppl.1), S1–S48. Available at: http://dx.doi.org/10.5014/ajot.2014.682006. Translated into Portuguese by Alessandra Cavalcanti, Fabiana Caetano Martins Silva e Dutra and Valéria Meirelles Carril Elui. Authorized translation for publication in Portuguese, open access on Revista de Terapia Ocupacional da Universidade de São Paulo.
• 2
  For Nilsson & Townsend (2010), occupational justice is the one that recognizes occupation as a right, therefore, aiming at participation for all people and collectives in daily occupations, minimizing differences in access to that right due to issues related to aspects such as age, ability, gender, social class, among others.
• How to cite: Gonçalves, M. V., & Malfitano, A. P. S. (2021). The concept of urban mobility: articulating actions in occupational therapy. Cadernos Brasileiros de Terapia Ocupacional, 29, e2523. https://doi.org/10.1590/2526-8910.ctoARF1929

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Edited by

Section editor Profa. Dra. Beatriz Prado Pereira

Publication Dates

• Publication in this collection
  25 June 2021
• Date of issue
  2021

History

• Received
  15 Apr 2019
• Reviewed
  12 June 2019
• Reviewed
  29 July 2019
• Accepted
  16 Aug 2019